Factors Associated with Complicated Appendicitis: View from a Low-middle Income Country

Khan, Muhammad Sohaib; Siddiqui, Muhammad Tayyab H; Shahzad, Noman; Haider, Aleezay; Chaudhry, Mustafa Belal Hafeez; Alvi, Rehman

doi:10.7759/cureus.4765

Cited by 15 publications

(22 citation statements)

References 27 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings have been confirmed in pediatric age group as well [5]. Khan et al recently described that odds of having appendicoliths was 2.4 times greater for patients with complicated appendicitis [14]. Therefore, while interpreting the CT scans of patients suspected to have acute appendicitis, consideration should be given to the size and number of appendicoliths.…”

Section: Discussionmentioning

confidence: 74%

The Characteristics of Appendicoliths Associated with Acute Appendicitis

Chaudhry¹,

Shahzad²,

Khan³

et al. 2019

Cureus

Self Cite

View full text Add to dashboard Cite

IntroductionDifferences between appendicoliths associated with appendicitis and those found incidentally have not been studied. The objective of this study was to determine the characteristics of appendicoliths that are associated with acute appendicitis.MethodsA cross-sectional study of patients with appendicoliths identified on computed tomographic (CT) scan from January 2008 till December 2014 was conducted. Patients were divided into two group: appendicitis and appendicoliths (AA) and incidentally discovered appendicoliths (IA).ResultsOverall, 321 patients were included in the study. Of these, 103 (32%) patients were in the AA group while 218 (68%) patients were in the IA group. Both groups were similar in age and gender distribution. Significantly greater proportion of patients in the AA group had more than one appendicolith [AA vs. IA: 63 (62%) vs. 82 (38%), p < 0.001], appendicolith location at the base [AA vs. IA: 34 (33%) vs. 33 (15%), p < 0.001] and appendicolith diameter of 5 mm or more [AA vs. IA: 71 (69%) vs. 28 (13%), p < 0.001]. On multivariate analysis, more than one appendicolith [Odds ratio (OR): 1.9, 95% CI: 1.1-3.4; p = 0.02] and diameter of 5 mm or more (OR: 13, 95% CI: 7.1-23.6; p < 0.001) were independently associated with acute appendicitis.ConclusionMultiple appendicoliths and appendicoliths larger than 5 mm are associated with acute appendicitis.

show abstract

Section: Discussionmentioning

confidence: 74%

The Characteristics of Appendicoliths Associated with Acute Appendicitis

Chaudhry¹,

Shahzad²,

Khan³

et al. 2019

Cureus

Self Cite

View full text Add to dashboard Cite

show abstract

“…We found increase in total leucocytes count in (40%).Most of cases presented with perforated appendix (20%), appendicular abscess (4.5%), and appendicular mass (18%), Peritonitis (18%) [1]. In another study was conducted in Pakistan 2015 mean age was 34.6 ±14 years, duration before pretension 2±1.2 days, management of mass 81% conservative 19% operated [4], In another study was conducted in Saudi Arabia in 2007 males to females ratio was 2:1. Average age was 29 years and duration before the pretension was 6.3 days, WBC increase in 83% of the cases [5].…”

Section: Introductionmentioning

confidence: 82%

Management of Complicated Appendicitis in Al-Thawra Modern General Hospital Sana'a -Yemen from November 2019 to November 2020

Obadiel¹

2021

Journal of Medical and Pharmaceutical Sciences

View full text Add to dashboard Cite

Background: Complicated appendicitis causes morbidity and mortality more than simple appendicitis. Complicated appendicitis includes appendicular mass, appendicular abscess, perforated appendicitis. Objective: To study presentation of complicated appendicitis regarding to age, sex and complain duration, also to study management of complicated appendicitis and his response to conservative management. Methods: A prospective, observational study was conducted in the department of general surgery at AL-Thawra hospital during the period from Nov 2019 to Nov2020. The data was collected using clinical examination and follow up, and was analyzed using SPSS 24. Results: A total of 57 patients diagnosed as complicated appendicitis, aged from 6 to 60 years were admitted, mean age was 28 years. Male to female ratio was 1.6:1. The complaint duration was more than 3 days in 34 cases (59%), total leucocytes count was >18 × 103 in 28 cases (49.1%). Twenty patients (35.1%) diagnosed as generalized peritonitis, 18 cases (31.6%) diagnosed as localized peritonitis, 14 patients (24.6%) diagnosed as appendicular mass, and 5 cases (8.8%) diagnosed as appendicular abscess. Forty cases (70.2%) underwent surgical intervention, whereas 17 cases (29.8%) improved with conservative management. Fifteen cases (37.5%) of operated patients underwent simple appendectomy and 13 cases (32.5%) underwent appendectomy with drain, and 12 cases (30%) underwent midline laparotomy. Most appendicular mass cases 12 (85.7%) were managed conservatively and 2 cases (14.3%) were operated. Three cases (60%) of appendicular abscess were aspirated, 2 cases (40%) were drained. Surgical site infection was 27.5% of operated cases. Conclusions: Complicated appendicitis can be suspected through clinical presentation, duration of complains and inflammatory response. Management of complicated appendicitis varies accordingly from conservative conventional to midline laparotomy.

show abstract

“…Imran JB et al reported that the median of APD in CA patients was longer than that in UA patients (2 days vs 1 day, p < 0.001), multivariate logistic regression analysis showed that APD was an independent predictor of CA (OR: 1.20; 95% CI, 1.07–1.37) ( 20 ). A recent study of CA patients in low- and middle-income countries also showed that the longer APD, the higher the incidence of CA, and surgeons should increase their awareness of the importance of APD in elderly patients ( 21 , 22 ). This study found that APD in elderly patients with CA was significantly longer than that in patients with UA (CA vs. UA: 50.80 ± 13.37 vs. 30.31 ± 16.78, p < 0.001]).…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Clinical Prediction Model for Complicated Appendicitis in the Elderly

Feng

Wang

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

BackgroundFor elderly patients with mild clinical symptoms of uncomplicated appendicitis(UA), non-surgical treatment has been shown to be feasible, whereas emergency surgical treatment is recommended in elderly patients with complicated appendicitis(CA), but it is still challenging to accurately distinguish CA and UA before treatment. This study aimed to develop a predictive model to assist clinicians to quickly determine the type of acute appendicitis.MethodsWe retrospectively studied the clinical data of elderly patients with acute appendicitis who visited the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2012 to January 2022. The patients were divided into UA group and CA group, and the general conditions, medical history, physical examination, laboratory examination and imaging examination were compared between the two groups, and SPSS 26.0 and R 4.0.2 software were used to establish CA clinic. Predict the model, and validate it internally.ResultsThe clinical data of 441 elderly patients with acute appendicitis were collected, 119 patients were excluded due to incomplete clinical data or other diseases. Finally, 332 patients were included in the study and divided into UA group (n = 229) and CA group (n = 103). By analyzing the clinical data of the two groups of patients, the duration of abdominal pain [OR = 1.094, 95% CI (1.056–1.134)], peritonitis [OR = 8.486, 95% CI (2.017–35.703))] and total bilirubin [OR = 1.987, 95% CI (1.627–2.426)] were independent predictors of CA (all p < 0.01). The model's Area Under Curve(AUC) = 0.985 (95% CI, 0.975–0.994). After internal verification by Bootstrap method, the model still has high discriminative ability (AUC = 0.983), and its predicted CA curve is still in good agreement with the actual clinical CA curve.ConclusionWe found that a clinical prediction model based on abdominal pain duration, peritonitis, and total bilirubin can help clinicians quickly and effectively identify UA or CA before treatment of acute appendicitis in the elderly, so as to make more scientific clinical decisions.

show abstract

Factors Associated with Complicated Appendicitis: View from a Low-middle Income Country

Cited by 15 publications

References 27 publications

The Characteristics of Appendicoliths Associated with Acute Appendicitis

The Characteristics of Appendicoliths Associated with Acute Appendicitis

Management of Complicated Appendicitis in Al-Thawra Modern General Hospital Sana'a -Yemen from November 2019 to November 2020

Development and Validation of a Clinical Prediction Model for Complicated Appendicitis in the Elderly

Contact Info

Product

Resources

About