Application of Tokyo criteria for the diagnosis of acute cholecystitis in the Adult Emergency Department of the Hospital Nacional, Itauguá
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Abstract
Introduction: approximately 10 % of people with cholelithiasis will develop Acute Cholecystitis. The Tokyo Guide, essential for diagnosis and classification, is used worldwide. Classification according to severity accurately predicts mortality, length of hospitalization, and laparotomy conversion rates. The criteria used are: characteristic signs and symptoms, findings of physical examinations, laboratory data and images.
Objectives: to evaluate the application of the Tokyo criteria for the diagnosis of acute cholecystitis in the Surgery Service, Adult Emergency Department of the Hospital Nacional.
Methodology: descriptive, cross-sectional and retrospective observational study. The files of patients who attended the Surgery Service, Adult Emergency Department of the Hospital Nacional between January 1 to September 1, 2019 were analyzed.
Results: of 66 patients studied, the average age was 45 years, with a predominance of females. 100 % presented pain in the right upper quadrant; In 73 %, elevated CRP was found, and the thickened gallbladder wall was the most frequent imaging sign, in 38 cases (58 %). 74 % met the criteria for a definitive diagnosis of acute cholecystitis.
Conclusions: the Tokyo guideline was a useful, applicable and necessary tool for the timely diagnosis of acute cholecystitis in patients at the Hospital Nacional. In addition, it is very valuable to classify it by severity and thus guide the appropriate treatment.
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