Vol 21. N°2. 2020  |  Abril-Junio de 2020


CASO CLÍNICO - NUTRICIÓN EN EL ADULTO MAYOR


REPORTE DE CASO. ABDOMEN AGUDO NUTRICIONAL EN EL ADULTO MAYOR: APENDAGITIS EPIPLOICA

Autores: ANALÍA YAMAGUCHI, LETICIA FERRO, SILVINA TASAT


RESUMEN

Se presentó un paciente de sexo masculino de 71 años de edad que consultó por un cuadro compatible con abdomen agudo médico de comienzo brusco. Refirió antecedentes de diabetes mellitus tipo 2, obesidad, dislipemia e hipertensión arterial. Al examen físico se encontró: afebril, presión arterial (PA) 128/75 mmHg; a la palpación del abdomen se halló un abdomen globoso, blando, depresible, doloroso en ambas fosas iliacas, signo de Mc Burney negativo, sin signos de reacción peritoneal, catarsis y diuresis conservadas. Se solicitó una tomografía computada (TC) abdominal con contraste oral y endovenoso (EV). La TC informó, a nivel del sigma sobre el borde antimesentérico, una imagen nodular de densidad grasa con halo hiperintenso y alteración tomodensitometría de la grasa adyacente, además de imágenes diverticulares no complicadas. Con el cuadro clínico del paciente y los hallazgos tomográficos se arribó al diagnóstico de apendagitis epiploica. Se inició tratamiento conservador con abordaje nutricional.

Palabras clave: dolor abdominal agudo; apendagitis epiploica.

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CASE REPORT. ACUTE NUTRITIONAL ABDOMEN IN THE ELDERLY: EPIPLOIC APPENDAGITIS

SUMMARY

71-year-old male patient with a sudden onset sharp medical abdomen. He reported a history of type 2 diabetes mellitus, obesity, dyslipidemia, high blood pressure. On physical examination, afebrile, blood pressure (BP) 128/75 mmHg, we founded a globose soft, depressible and abdomen, painful in both iliac fossae; negative Mc Burney sign, with no signs of peritoneal reaction, catharsis and diuresis were preserved. We did not find any alteration on abdominal ultrasound. Computed tomography (CT) reported at the sigma level on the antimesenteric border a nodular fat density image with hyperintense halo with tomodensitometry alteration of the adjacent fat. With the clinical picture of the patient and the tomographic findings, we arrived at the diagnosis of epiploic apendagitis. Conservative treatment with a nutritional approach was started.

Key words: epiploic appendagitis; acute abdomen.


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