DOI: http://dx.doi.org/10.18203/2349-2902.isj20192959

Surgical outcome in patients with complicated appendicitis treated at a medical college hospital

Pramod T., Prakashkumar M. N.

Abstract


Background: Acute appendicitis is the most common surgical emergency requiring operative intervention. Most of the cases are simple; however complicated appendicitis with perforation, abscess and gangrene of appendix is seen in up to 1/4th of adults and 1/3rd of cases in children. It is associated with post operative complications with considerable morbidity. The aim is to study the clinical presentation of complicated appendicitis, the intra-operative findings, post-operative complications and the overall surgical outcome.

Methods: It is a cross sectional study of 35 patients who had complicated appendicitis and who were treated with surgery.

Results: 83% of patients with complicated appendicitis were younger than 40 years of age, with children constituting about 43% of total cases. All the patients had typical right iliac fossa pain, with tenderness and localized guarding in 37%. Ultrasound diagnosed appendicitis in 80% of cases. Leukocytosis was seen in 71% with neutrophil shift in 85% of patients. 60% of patients had perforation and abscess formation, gangrene in 45% and mass in 37%. Post operative complications were noted in 51% of the patients, commonly paralytic ileus (46%) and wound infection (20%). There was no mortality in our study and the general overall outcome of treatment was good.

Conclusions: Complicated appendicitis with gangrene, perforation and abscess form a considerable proportion of cases. Early surgical intervention is the definitive treatment after initial resuscitation. Overall morbidity is considerable, but mortality is less than 1% and the general overall outcome is good with early surgical intervention.


Keywords


Complicated appendicitis, Gangrene, Perforation, SSI

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