OMENTAL INFARCTION: SURGICAL or CONSERVATIVE TREATMENT? A CASE REPORTS and CASE SERIES SYSTEMATIC REVIEW
| Autor: | N.A. Medina-Gallardo, J. Gardenyes, P. Roura-Poch, Y. Curbelo-Peña, T. Stickar, H. Vallverdú-Cartie, S. Fernández-Planas |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Omental infarction Abdominal pain Acute abdominal pain Review Article Logistic regression 03 medical and health sciences 0302 clinical medicine Chi-square test medicine Surgical treatment Computed tomography Series (stratigraphy) business.industry General surgery General Medicine medicine.disease Conservative treatment Exact test 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery medicine.symptom business |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Background Omental infarction (OI) is an infrequent cause of acute abdominal pain and there is no consensus on whether conservative or surgical treatment is the best strategy when performing positive CT diagnosis. Objectives To assess which of the two treatments is the most commonly adopted and compare outcomes in terms of success rate in resolution of symptoms and hospital length of stay. Eligibility criteria Case report and case series of patients with abdominal pain and positive diagnosis by CT of omental infarction. Data sources PubMed, Science Direct and Google Scholar in combination with cross-referencing searches and manual searches of eligible articles from January 2000 to June 2018. Participants Patients older than 18 years of age. Methods Patient characteristics and results were summarized descriptively. Categorical variables were assessed by chisquare test or Fischer's exact test, and continuous variables by the Wilcoxon-Mann-Whitney or Kruskal-Wallis test. Risk factors for failure of the conservative management were identified using multivariate logistic regression. Results 90 articles were included in the final analysis (146 patients). 107 patients (73.3%) received conservative treatment with a failure rate of 15.9% (patients needing surgery) and 39 patients (26.7%) received surgery as first treatment. The mean hospital length of stay was 5.1 days for the conservative treatment group and 2.5 days for the surgery group with statistically significant differences (p = 0.00). Younger age and white blood cells count ≥12000/μl were predictive factors of conservative treatment failure. Conclusions Although conservative treatment is effective in most patients, surgery has advantages in terms of hospital length of stay. Highlights • Conservative treatment seems to be the preferred option when making a CT diagnosis of omental infarction. • However, it fails in 15% of patients, needing surgery sometimes with worse local conditions due to evolutive complications. • Surgical treatment, especially through the laparoscopic approach, appears to be safe and involves a shorter hospital stay. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|