Abdominal manipulation and other cultural risk factors associated with complication of acute appendicitis in pediatric patients

Aguilar-Andino, David; Licona Rivera, Tania Soledad; Osejo Quan, Jorge Alberto; Carranza Linares, Ricardo Jafet; Molina Soto, Marco Antonio; Alas-Pineda, César

Manipulación abdominal y otros factores de riesgo culturales asociados a complicación de apendicitis aguda en pacientes pediátricos

dc.contributor		en-US
dc.contributor		es-ES
dc.creator	Aguilar-Andino, David
dc.creator	Licona Rivera, Tania Soledad
dc.creator	Osejo Quan, Jorge Alberto
dc.creator	Carranza Linares, Ricardo Jafet
dc.creator	Molina Soto, Marco Antonio
dc.creator	Alas-Pineda, César
dc.date	2023-02-21
dc.identifier	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4218
dc.identifier	10.32641/andespediatr.v94i1.4218
dc.description	In children, acute appendicitis (AA) is usually mistaken for empacho, which, according to popular belief, is caused by the ingestion of undercooked or cold food causing gastrointestinal symptoms. The empirical treatment is abdominal manipulation, consisting of massages with different maneuvers on the abdominal wall, accompanied by home remedies. The effect of these therapies in the presence of AA is unknown. Objective: To determine the association between abdominal manipulation and complicated AA in pediatric patients. Patients and Method: Case-control study in a pediatric population under 18 years of age, with acute abdomen symptoms, who underwent surgery for AA, in a tertiary health institution in Honduras. Cases were defined as patients with complicated AA and controls as those with simple AA. A binary logistic regression model was used to determine the risk factors associated with complications of AA. Results: Sixty-two pediatric patients were analyzed (31 cases and 31 controls) with a median age of 11 years. 58.1% were from an urban area. 77.4% of the cases and 9.7% of controls had a history of abdominal manipulation. The most frequent initial symptom was abdominal pain. In the univariate analysis, male sex, prolonged evolution time, use of home remedies, leukocytosis > 20,000/mm3, and abdominal manipulation were risk factors for complicated AA. In the multivariate model, abdominal manipulation was the main risk factor (OR 15.94 [3.40- 74.59]). Conclusion: Cultural beliefs such as empacho and its respective treatments such as abdominal manipulation and use of home remedies are risk factors for the complication of an established AA case, as well as contributing to the delay in diagnosis.	en-US
dc.description	La apendicitis aguda (AA) en niños usualmente es confundida con empacho, enfermedad que, según creencia popular, se produce por ingesta de alimentos mal cocidos o fríos causando síntomas gastrointestinales. El tratamiento empírico es la manipulación abdominal, que consiste en masaje con distintas maniobras sobre la pared abdominal, acompañado de remedios caseros. Se desconoce el efecto de dichas terapias en la evolución de AA. Objetivo: Determinar la asociación entre manipulación abdominal y AA complicada en pacientes pediátricos. Pacientes y Método: Estudio de casos y controles en menores de 18 años, con cuadro de abdomen agudo, intervenidos quirúrgicamente por AA, en un centro hospitalario de Honduras. Se definió como casos los pacientes con AA complicada y controles aquellos con AA simple. Se empleó un modelo regresión logística binaria para determinar los factores de riesgo asociados a complicaciones de AA. Resultados: Se enrolaron 31 casos y 31 controles, mediana de edad 11 años. El 58,1% procedía de una zona urbana. El 77,4% de los casos y 9,7% de los controles tuvo antecedente de manipulación abdominal. El síntoma inicial más frecuente fue dolor abdominal. En análisis univariado el sexo masculino, tiempo de evolución prolongado, uso de remedios caseros, leucocitosis > 20,000/mm3 y manipulación abdominal fueron factores de riesgo para AA complicada. En modelo multivariado, la manipulación abdominal fue el principal factor de riesgo (OR 15,94 [3,40-74,59]). Conclusión: Creencias culturales como el empacho y sus respectivos tratamientos como la manipulación abdominal y los remedios caseros, son factores de riesgo para la complicación de un cuadro instaurado de AA, así mismo contribuyen al retraso diagnóstico.	es-ES
dc.format	application/pdf
dc.format	application/pdf
dc.language	spa
dc.language	eng
dc.publisher	Sociedad Chilena de Pediatría	es-ES
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4218/4227
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4218/4412
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4218/13833
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4218/13834
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4218/13835
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4218/13889
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4218/13874
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4218/15162
dc.rights	Copyright (c) 2023 Andes Pediatrica	es-ES
dc.rights	http://creativecommons.org/licenses/by/4.0	es-ES
dc.source	Revista Chilena de Pediatría; Vol. 94, Núm. 1 (2023): Enero - Febrero; 45-53	en-US
dc.source	Andes Pediatrica; Vol. 94, Núm. 1 (2023): Enero - Febrero; 45-53	es-ES
dc.source	2452-6053
dc.source	2452-6053
dc.subject		en-US
dc.subject	Appendicitis; Acute Abdomen; Perforated Appendicitis; Ethnography; Traditional Medicine; Emergency Medicine; Pediatrics	en-US
dc.subject		es-ES
dc.subject	Apendicitis; Abdomen Agudo; Apendicitis Perforada; Etnografía; Medicina Popular; Medicina de Emergencia; Pediatría	es-ES
dc.title	Abdominal manipulation and other cultural risk factors associated with complication of acute appendicitis in pediatric patients	en-US
dc.title	Manipulación abdominal y otros factores de riesgo culturales asociados a complicación de apendicitis aguda en pacientes pediátricos	es-ES
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/publishedVersion
dc.type		en-US
dc.type		es-ES

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