Acute Appendicitis – A Benign Disease?

Abstract

The treatment of choice is appendicectomy and trials have suggested that, although the laparoscopic approach may have some advantages, there is no clear benefit of this over the open approach. As a consequence, the method of appendicectomy is often dictated by operator experience and facilities available. The majority of recent studies on the management of patients having an appendicectomy are from within the confines of a clinical trial and, due to selection criteria, do not reflect the whole patient case load undergoing the procedure. Most patients recover quickly from appendicectomy but a minority can suffer postoperative complications. This review of case notes was undertaken to assess the frequency of these complications in unselected patients. Patients and MethodsAdult patients (> 16 years of age) undergoing an emergency appendicectomy in the 12-month period between 1 February 2004 and 31 January 2005 were identified from a key word search of 'appendix' from pathology and theatre record databases. Details of presenting symptoms, time to operation, operative procedure, histology and postoperative complications were obtained from the patients' case notes. A complicated recovery was assumed to have occurred if a patient did not recover in the conventional manner. This was defined by the presence of a complication which prolonged the postoperative stay for >4days, admission to a critical care area and/or the need for re-operation or re-admission. Complications were divided into septic (i.e. infective) or non-septic depending on the nature and aetiology. Appendicitis is the most common cause of the acute abdomen and can affect all age groups. Most patients recover quickly but a minority can suffer postoperative complications. This case-note review was undertaken to assess the frequency of these complications.

Spectrum of Diseases in Patients With Non-Traumatic Acute Abdomen

“…(7) Male predominance noticed in this study is similar to the studies conducted locally and in west. Appendicitis was the most common cause of acute abdomen in this study, consistent with other studies carried in England and locally, (8)(9)(10) which also stated it to be more common between ages 10 and 20 years, as in this study but no age is exempted. Most patients in our study presented with migratory pain in RIF, with pyrexia and rebound tenderness in RIF on examination, but none of these are specific for appendicitis.…”

Demographic and Epidemiologic Features of Acute Appendicitis

“…Acute Appendicitis (AA) is the most commonly encountered disease in emergency clinics, with about 250,000 cases of appendicitis reported in The United States and 40,000 in England each year (Deng et al, 2010;Simpson et al, 2008). The key form of treatment for the disease is surgery and the mortality, morbidity, and economic cost ratio rise the longer it remains untreated.…”

Study on the Feasibility and the Safety of Hem-o-lok Clipping for Complicated Acute Appendicitis during Laparoscopic Appendectomy

“…1 Laparoscopic appendectomy has been accepted as a standard treatment modality and its usage is increasing, although a comparatively recent analysis of 259,735 appendectomies performed in British NHS hospitals from 1996 to 2006 showed that laparoscopic appendectomy accounted for only 6.3% of all procedures performed. 2 Nevertheless, laparoscopic appendectomy has been shown to be safe, and is associated with fewer postoperative complications and faster recovery than open appendectomy.…”

“…1,3 Acute appendicitis is one of the most common emergent diseases that surgeons encounter in daily practice. However, complicated appendicitis can result in significant morbidity.…”