Frecuencia del antecedente de constipación en pacientes con apendicitis aguda hospitalizados en el Servicio de Cirugía del Hospital Naval Sur de Guayaquil, período 2022–2025.

Abstract

Introduction: Acute appendicitis is the leading cause of acute surgical abdomen and may progress from uncomplicated to complicated forms, including perforation, gangrene, abscess, among others. Constipation has been identified as a possible associated antecedent related to alterations in intestinal transit and fecalith formation; however, at present, this association, although appropriately hypothesized, does not imply causality and should be evaluated in specific hospital-based populations. Objective: To determine the frequency of a history of constipation and its relationship with the clinical and evolutionary characteristics of acute appendicitis in the population hospitalized in the Surgery Department of Hospital Naval Sur in Guayaquil during the 2022–2025 period. Methods: An observational, analytical, cross-sectional, retrospective study was conducted, using a quantitative approach with a descriptive component, through a review of medical records and institutional registries. A history of constipation, ICD-10 diagnosis, presence of fecaliths, perforation, gangrene, abscess, and length of hospital stay were analyzed. Categorical variables were compared using Chi-square or Fisher’s exact tests, as appropriate, and odds ratios (ORs) with 95% confidence intervals were estimated. Results: A total of 347 cases of acute appendicitis were analyzed. A history of constipation was recorded in 118 patients (34.0%) and was not recorded in 229 patients (66.0%). The presence of fecaliths was higher in patients with constipation than in those without this history (35.6% vs. 13.5%; OR=3.53; 95% CI: 2.07–6.02; p<0.001). A higher frequency of perforation (15.3% vs. 5.2%; OR=3.25; 95% CI: 1.51–7.02; p=0.002) and gangrene (11.9% vs. 4.4%; OR=2.95; 95% CI: 1.27–6.86; p=0.009) was also observed. Regarding abscess, a higher frequency was observed in the constipation group (7.6% vs. 3.1%), although the association did not reach statistical significance (OR=2.62; 95% CI: 0.95–7.22; p=0.055). A hospital stay of ≥7 days was also more frequent among patients with constipation (22.0% vs. 10.0%; OR=2.53; 95% CI: 1.37–4.67; p=0.002). Conclusion: A history of constipation was present in approximately one-third of the cases studied and was statistically associated with a higher frequency of fecaliths, perforation, gangrene, and hospital stays of ≥7 days. The association with abscess did not reach statistical significance.