Pattern of presentation and outcome of management of acute appendicitis: A 10-year experience

Abstract

Background: Appendicitis is one of the most common indications for nonelective abdominal surgery. This is true in both developed and developing countries. The aim of this study was to describe the pattern of presentation and outcome of management in a large hospital in the developing world. Methods: All patients of the general surgery divisions who had appendicectomy for clinical preoperative diagnosis of acute appendicitis between July 2007 and June 2016 were included in the study. Patients who had incidental appendicectomy were excluded from the study. Data were collected retrospectively using a data collection instrument designed for the study. Results: The total number of appendicectomy operations performed within the stipulated period was 1081. Male:female ratio was 1.37:1. The age range was from 12 years to 80 years. The most common symptom and sign remain the right lower quadrant pain and right iliac fossa tenderness, respectively. The duration of symptoms before presentation ranged from 10 h to 96 h. Approximately 20% or a fifth of the patients had ruptured appendix. Tumor associated appendicitis constituted 2.2%. The negative appendicectomy rate was 9.5%. About 47% of the patients were discharged <72 h after surgery. There were five mortalities in all. Conclusion: The diagnosis of acute appendicitis in the developing world may still be done with acceptable levels of accuracy based on in-depth medical history and clinical examination.

Keywords

• Acute appendicitis
• outcome
• presentation