Acute perforated appendicitis in adults: Management and complications in Lagos, Nigeria

Balogun, Olanrewaju Samuel; Osinowo, Adedapo Olumide; Afolayan, Michael; Olajide, Thomas; Lawal, A O; Adesanya, AA

doi:10.4103/aam.aam_11_18

Cited by 31 publications

(32 citation statements)

References 19 publications

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“…Males have been reported present more often with perforated appendixes 16 However, in our study, no significant dominance of either gender was observed (p-value). There was no significant difference in age was also found in both age groups.…”

Section: Discussioncontrasting

confidence: 83%

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Perforated appendicitis: Can it be a bedside diagnosis?

Tariq

Malik

Changeez

et al. 2020

TPMJ

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Appendicitis remains one of the most common causes of acute abdomen worldwide. It presents as a spectrum of disease ranging from an acutely inflamed appendix to a perforated one. Where acutely inflamed can be managed conservatively, a perforated appendix always needs surgery to prevent complications like pelvic abscesses. Bedside diagnosis remains relevant in our setup. Objectives: To determine whether history, clinical examination, and basic laboratory investigations can help in confident bedside diagnosis of perforated appendicitis especially in the absence of sophisticated diagnostic modalities. Study Design: Retrospective Case-control study. Setting: Surgical Unit-1, Holy Family Hospital. Period: Jan 2016 to Dec 2016. Material & Methods: Conducted at Hospital records of patients who underwent open appendectomy in the year 2016 were reviewed. Two groups of 100 patients each were made based on per operative findings. Appendices having macroscopic holes in the base or tip were labeled as perforated. Group A had acutely inflamed appendix and group b had perforated appendix. Patients’ demographic details were taken from hospital admission tickets. Findings of history and examination were retrieved from treating resident and operating surgeon's notes. Data were analyzed through SPSS. Results: Out of 200 patients the total number of males was 102 (51%) and females were 98 (49%). Mean age was 24.13+9.73 in males and 18.7+ 6.4 in females of group A and 26.0+10.1 in males and 20.56+7.53 in females of Group B. Group B showed a significant delay in presentation to emergency after the onset of pain (P = 0.022). Upon history and clinical examination, the presence of anorexia, malaise, generalized abdominal pain, guarding, mass in right iliac fossa were significantly associated with perforation. Whereas gender, fever, vomiting, and dysuria showed no association with perforation. Conclusion: Bedside conventional methods of history taking and examination remain a useful tool in anticipating perforated appendicitis. This helps surgeons in planning incisions and prioritizing patients on heavy operating lists. This remains especially relevant in resource-constrained setups where sophisticated modalities like CT scans are largely unavailable.

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Section: Discussioncontrasting

confidence: 83%

“…While this holds for all equivocal cases, authors believe that in all overt cases of peritonitis, early intervention might have a positive role in limiting postoperative SIRS. 16…”

Section: Discussionmentioning

confidence: 99%

Perforated appendicitis: Can it be a bedside diagnosis?

Tariq

Malik

Changeez

et al. 2020

TPMJ

View full text Add to dashboard Cite

show abstract

“…Males have been reported present more often with perforated appendixes (16). However, in our study, no significant dominance of either gender was observed (p-value).…”

Section: Discussioncontrasting

confidence: 81%

Perforated appendicitis: can it be a bedside diagnosis?

Tariq

Malik

Yaqoob

et al. 2020

Preprint

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INTRODUCTION: Appendicitis remains one of the most common causes of acute abdomen worldwide. It presents as a spectrum of disease ranging from an acutely inflamed appendix to a perforated one. where acutely inflamed can be managed conservatively, a perforated appendix always needs surgery to prevent complications like pelvic abscesses. Bedside diagnosis remains relevant in our setup. AIMS AND OBJECTIVES: To determine whether history, clinical examination, and basic laboratory investigations can help in confident bedside diagnosis of perforated appendicitis especially in the absence of sophisticated diagnostic modalities. MATERIALS AND METHODS: A retrospective case-control study was conducted. Hospital records of patients who underwent open appendectomy in the year 2016 were reviewed. Two groups of 100 patients each were made based on per operative findings. Appendices having macroscopic holes in the base or tip were labeled as perforated. Group A had acutely inflamed appendix and group b had perforated appendix. The patient's demographic details were taken from hospital admission tickets. Findings of history and examination were retrieved from treating resident and operating surgeon's notes. Data were analyzed through SPSS. RESULTS: Out of 200 patients the total number of males was 102 (51%) and females were 98 (49%). Mean age was 24.13+9.73 in males and 18.7+ 6.4 in females of group A and 26.0+10.1 in males and 20.56+7.53 in females of Group B. Group B showed a significant delay in presentation to emergency after the onset of pain (P = 0.022). Upon history and clinical examination, the presence of anorexia, malaise, generalized abdominal pain, guarding, mass in right iliac fossa were significantly associated with perforation. Whereas gender, fever, vomiting, and dysuria showed no association with perforation. CONCLUSION: Bedside conventional methods of history taking and examination remain a useful tool in anticipating perforated appendicitis. This helps surgeons in planning incisions and prioritizing patients on heavy operating lists. This remains especially relevant in resource-constrained setups where sophisticated modalities like CT scans are largely unavailable. KEYWORDS: Perforated appendicitis, Acute appendicitis

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“…The common complication of appendicitis could be the perforation, abscess formation and appendicular lump. 24 In our study, the patients' age ranged from 8 years to 76 years with mean age 35±15.6 with maximum incidence 87.4 % below 50 years. This result is nearly consistent with several studies that report 95 % appendicitis below 50 years age.…”

Section: Discussionmentioning

confidence: 70%

Morbidity and Mortality Pattern of Appendicitis in Rural Teaching Hospital of Nepal

Menyangbo

Bhatta

Subedi

et al. 2020

J. Karnali Acad. Health Sci.

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Background: Acute appendicitis is the most common cause of surgical acute abdomen. It contributes for 40 % of all emergency performed abdominal surgeries in western world and 26 % it accounts for in Nepal. The treatment of acute appendicitis remains a health problem and considerable morbidity and mortality are still associated with it. Perforation, abscess formation, appendicular lump and surgical site of infection are well reported morbidities. Late arrival in hospital and use of inadequate dose of antibiotics in local might have association in increasing morbidities. The aim of the study is to observe the morbidity and mortality in appendicitis patients belonging to this Midwestern region of Nepal. Methods: This retrospective cross sectional study was carried out in the Karnali academy of health sciences, Jumla Nepal. The data includes the 5 years period from Jan 2014 to March 2020. The parameters included admission of acute appendicitis, age, gender, post-operative findings and complication. Results: There were 186 cases collectively. 175 cases of appendicitis were recorded. The mean age was 31±15.16. Ninety two (52.6%) were female; 83(47.4%) were male. 119(68%) had appendectomies. 56(32%) were treated conservatively. 29(51.78%) were appendicular lump and 27(48.2%) were suspected appendicitis. Five were found to have perforation of appendix. Two had abscess in 29 cases of appendicular mass. 2 had surgical site infection. Conclusion: Among patients who were admitted in the hospital with diagnosis of acute appendicitis, the commonest complication is the appendicular lump, which might be due to late hospital arrival or early antibiotics use impulsively at local level, followed by perforation appendix. The result supports both appendectomy and conservative treatment are equally feasible for acute appendicitis accordingly the cases presented in the hospital.

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Acute perforated appendicitis in adults: Management and complications in Lagos, Nigeria

Cited by 31 publications

References 19 publications

Perforated appendicitis: Can it be a bedside diagnosis?

Perforated appendicitis: Can it be a bedside diagnosis?

Perforated appendicitis: can it be a bedside diagnosis?

Morbidity and Mortality Pattern of Appendicitis in Rural Teaching Hospital of Nepal

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