A comparative study of perforated and non-perforated appendicitis with respect to clinical findings, radiological findings and post-operative management

Ghag, Geeta; Shukla, Kamal S.; B.Shukla, Dhiraj kumar; Bhalerao, Upendra D.

doi:10.21276/apjhs.2016.3.4s.2

Cited by 4 publications

(9 citation statements)

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“…The findings suggest that the most common age group presenting with perforated appendicitis was 21–30 years of age (31.8%) with the youngest patient of 12 years and oldest 78 years, with the mean age of 32.5 years (Table 1 ). These findings were in accordance with studies done by Ghag et al 7 and Balogun et al 8 where the most common age group was also 21–30 years of age. Data suggests the male preponderance with male : female ratio of 1.47 : 1, thus, correlating with studies done by Drake et al .…”

Section: Discussionsupporting

confidence: 93%

“…These findings correlate with studies done by Omari et al . 12 , Sirikurnpiboon et al 13 , Ghag et al 7 , Shirah et al 6 , Anandaravi et al . 14 , and Balogun et al .…”

Section: Discussionmentioning

confidence: 99%

“…The interpretation of the data (Table 6 ) suggests that 89 patients (78.1%) had less than 50 millilitre (mild) peritoneal collection, 14 patients (12.3%) had 50–150 ml (moderate) peritoneal collection, and 11 patients (9.6%) had more than 150 ml (severe) peritoneal collection, which was found similar to Ghag et al . 7 . The rate of complications in patients with mild, moderate, and severe peritoneal collection was 42, 80, and 100%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Study of outcomes of perforated appendicitis in adults: a prospective cohort study

Potey

Kandi

Jadhav

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Acute appendicitis remains the most common general surgical emergency seen in most hospitals and the most common cause of acute abdomen requiring surgical intervention. Aim: The aim was to study the intraoperative features and postoperative outcomes of appendicular perforation in adults. Objectives: First, to study the incidence, clinical presentation, and complications of perforated appendicitis in a tertiary care hospital. Second, to study morbidity and mortality in an operated case of perforated appendicitis. Materials and Methods: This prospective observational study was conducted at a tertiary care centre in a government setup from August 2017 to July 2019. Data were collected from patients ( N =126) who had an intraoperative finding of perforated appendicitis. The inclusion criteria are as follows: patients over the age of 12 with a perforated appendix, as well as any patients with intraoperative findings like perforated appendicitis, gangrenous perforated appendicitis, or a disintegrated appendix. The exclusion criteria are as follows: all patients with appendicitis below 12 years of age with perforated appendicitis; all patients with appendicitis with intraoperative findings of acute nonperforated appendicitis; and all patients with intraoperative findings of an appendicular lump or mass. Results: Perforation was found in 13.8% of the cases of acute appendicitis in this study. With a mean age of 32.5 years, the most common age of presentation in perforated appendicitis was 21–30 years. The most prevalent presenting symptom in all patients (100%) was abdominal pain, followed by vomiting (64.3%) and fever (38.9%). Patients with perforated appendicitis had a 72.2% complication rate. Peritoneal pollution of more than 150 ml was linked to a 100% increase in morbidity and mortality (54.5%). The mean duration of the hospital stay in patients with a perforated appendix was 7.28±5 days. Surgical site infection (42%) was the most common early complication, followed by wound dehiscence (16.6%), intestinal obstruction (1.6%), and faecal fistula (1.6%). The most common late complications were intestinal obstruction (2.4%), intra-abdominal abscess (1.6%), and incisional hernia (1.6%). The mortality rate in patients with perforated appendicitis was 4.8%. Conclusion: To conclude, prehospital delay was an important factor contributing to appendicular perforation and leading to adverse outcomes. A higher rate of morbidity and prolonged duration of hospital stay were seen in patients with delayed presentation, with features of generalised peritonitis and perforation of the base of the appendix. Delayed presentations in as elderly population with underlying co-morbid conditions associated with severe peritoneal contamination were associated with higher mortality (26%) in perforated appendicitis. Conventional surgery and open procedu...

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Section: Discussionsupporting

confidence: 93%

“…These findings correlate with studies done by Omari et al . 12 , Sirikurnpiboon et al 13 , Ghag et al 7 , Shirah et al 6 , Anandaravi et al . 14 , and Balogun et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Study of outcomes of perforated appendicitis in adults: a prospective cohort study

Potey

Kandi

Jadhav

et al. 2023

Annals of Medicine &Amp; Surgery

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“…Alvarado score is best preoperative determinant of appendicitis and can predict the likelihood of perforation in select cases. 6 This findings regarding to Alvarado score are similar to this study. These results are also comparable to those reported by Dey S Jawaid A, Baidya N, Chan MY, and Khan I.…”

Section: Discussionsupporting

confidence: 91%

Diagnostic value of C-reactive protein as a predictor of complicated appendicitis like perforated/gangrenous appendicitis

Choudhary¹,

Yadav²,

Gupta³

et al. 2019

Int Surg J

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Background: Appendicitis is inflammation of appendix. Appendicitis remains the most common abdominal surgical emergency. There is no reliable specific marker for acute appendicitis and its complications. C- reactive protein is an acute phase reactant produced by the liver during the acute inflammation, which rises rapidly in presence of inflammation. CRP is a more sensitive and reliable indicator of inflammatory processes than ESR and leucocyte count. The aim of this study was to evaluate whether CRP predict the severity of appendicitis.Methods: This study was hospital based, observational study. After history and clinical examination, patient underwent USG whole abdomen. Diagnosis of appendicitis was established. After that patient underwent routine blood investigations including, CRP. After confirming diagnosis of appendicitis, patients underwent appendectomy and biopsy of appendix was sent for histopathological examination.Results: In our study, CRP value > 6.15mg/L has a sensitivity of 100.0% and a specificity of 54% in predicting complicated perforated or gangrenous appendicitis. The positive predictive value and negative predictive value of CRP were 100% and 61.54% respectively. The cut off level at around 6mg/dL needs to be handled carefully and a person with high CRP should undergo surgery immediately.Conclusions: This study clearly suggested that CRP leads to precise prediction of the severity of acute appendicitis for treatment. A person with high CRP should undergo surgery immediately ures.

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“…Mean TSB were 0.94±0.33mg/dL, 1.85±0.56mg/dL and 1.67±0.32mg/dL in Group A, Group G and Group P respectively. Group G and P (P<0.001) had significantly higher TSB than Group A. Hyperbilirubenemia was observed in 15 Mean Alvarado Score was 7.86±2.04 in all groups. Mean Alvarado Score was 6.86±2.21, 8.75±0.97 and 9.07±0.95 Group A, Group G and Group P respectively.…”

Section: Results-mentioning

confidence: 81%

A Prospective Observational Study to Assess Role of Isolated Hyperbilirubinemia to Predict Gangrenous/Perforated Appendicitis

Choudhary

Bharti

Nagar³

et al. 2021

PIJR

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Aim:Theaimof studywas toassess theroleofhyperbilirubinemiaasapredictorofgangrenousorperforated appendicitis. Introduction: Appendicitis is characterised by means of infection and inflammation of the appendix. It was hypothesized that an association exists between the presence of appendiceal perforation and hyperbilirubinemia.The present study has been designed to evaluate the association between hyperbilirubinemia in cases of acute appendicitis and its complications. Methods: This study was conducted at SMS hospital Jaipur as a prospective observational study. One hundred twenty patients of appendicitis were enrolled from 1 March 2017 to 30 November 2018 according sample size. Patients underwent appendectomy after confirmation of diagnosis by USG and other investigations and biopsy was sent for histopathological examination. Results: Total 120 patients were analysed In our study as per inclusion criteria. Hyperbilirubinemia (>1.2 mg/dL) was found in gangrenous appendicitis and perforated appendicitis (91.67% and 100% respectively) as compared to in acute appendicitis (15.63%) cases (P<0.001). most of the acute (84.37%) and some gangrenous appendicitis (8.33%) patients had normal TSB but all perforated appendicitis patients had hyperbilirubinemia (>1.2 mg/dL). Liver enzymes were normal in most of cases or slightly elevated in some cases.Alvarado Score and CRP were also significantly elevated in complicated appendicitis than acute appendicitis. Conclusion: Our study concluded that isolated hyperbilirubinemia is a predictor of perforated or gangrenous appendicitis.High Alvarado Score and CRP level are also indicating complicated appendicitis.

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A comparative study of perforated and non-perforated appendicitis with respect to clinical findings, radiological findings and post-operative management

Cited by 4 publications

References 0 publications

Study of outcomes of perforated appendicitis in adults: a prospective cohort study

Study of outcomes of perforated appendicitis in adults: a prospective cohort study

Diagnostic value of C-reactive protein as a predictor of complicated appendicitis like perforated/gangrenous appendicitis

A Prospective Observational Study to Assess Role of Isolated Hyperbilirubinemia to Predict Gangrenous/Perforated Appendicitis

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