Abdomen agudo ginecoobstétrico: Experiencia en el Hospital Edgardo Rebagliati Martins, IPSS.

Abstract

OBJECTIVE.- Review of cases of acute abdomen in gynecology and obstetries. DESIGN.- Retrospective study. SETTING: Obstetrical and Surgery Emergenty Services of Edgardo Rebagliati Martíns National Hospital, Peruvian Institute of Social Security. PATIENTS AND INTERVTNTIONS.- One hundred one cases of acute abdomen of ginecologic and obstetrical origin (AGOA) who had laparotomy. RESULTS: Most frequent AGOA at our hospital were the hemorrhagic type, mainly due to ruptured ectopic pregnancy, followed by vascular AGOA mainly due to ovarian cyst with torsíon of the pedicle. Most of the inflamatory AGOA were actually adnexitis and should not have required laparotomy. The ovary was involved in one third of the cases, mainly due to torsion of the cyst pedicle,- treatment consisted in oophorectomy. Another case was due to hydrosalpinx with torsion. Pathology associated to pregnancy, labor and pueperium occurred in hal of all cases and included mostly ruptured ectopic pregnancy and some cases of acute appendicitis, ovarian cysts with torsion, uterine rupture, uterine perforation, post cesarean section hemorrhage, peliviperitonitis due to septic abortion, puerperal parametritis, intestinal obstruction, and closed abdominal trauma. CONCLUSIONS: Women in reproductive age are liable to abdomino-pelvic diseases that require emergency surgical intervention. Diagnosis may be complicated by pregnancy. Management requires experience, accurate diagnosis and early and appropiate treatment. Ultrasound and laparoscopy should be done routinely in the emergeney room, and special tests such as beta subunit chorionic gonadotrophins and special hematologic studies should be available at all times.