ABSTRACT

Aim: To evaluate the major factors affecting the clinical outcome in the management of acute appendicitis

Study Design: Prospective case series study

Settings: South Surgical Ward Mayo Hospital, Lahore

Duration: April to September 2019

Methods: All the patients above 12 years of age with the clinical diagnosis of acute appendicitis admitted through Accident and Emergency Department Mayo Hospital, Lahore were included in the study

Results: Age ranged from 13-65 with the mean of 25 + 11 years and 57% of the patients were male. Duration of pain recorded was <24 hours in 55%, nausea/vomiting in 76%, anorexia in 55% and fever in 47% of the patients. Abdominal tenderness and Blumberg’s sign were found in all the patients. 99% of the patients underwent surgical management. Among operative findings, perforated appendix with its complications was found in 20%, ovarian cyst in 6%, ruptured ectopic pregnancy in 1.5% and distal ileum perforation in 1% of the patients. Surgical site infection was observed in 13% and pelvic abscess in 2% of the patients postoperatively. There was no mortality.

Conclusion: Acute appendicitis is the most common cause of acute abdomen remains a challenging task for the surgeons worldwide. The complications of the perforated appendix are associated with significant morbidity and even mortality in the developing countries. The major factors contributing for the advanced disease profile and its complications in the developing world are poverty, late clinical presentation, misdiagnosis, elderly age and lack of latest diagnostic aids in the Emergency Departments.

Keywords: Acute appendicitis, perforated appendix, major factors, peritonitis, appendicectomy, morbidity