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

Abstract

Introduction: The vermiform appendix is considered by most to be a vestigial organ, its importance in surgery is only due to its tendency for inflammation resulting in the syndrome called acute appendicitis. Acute appendicitis is the most common cause of an “acute abdomen” in young adults. Appendectomy is the most frequently performed emergency abdominal operation. Present study was undertaken to evaluate the intraoperative features and postoperative outcome in pts with acute appendicitis presenting with or without perforation and to evaluate the relative importance of these determinants, effect of preoperative delay, prehospital antibiotic therapy with postoperative morbidity of perforated acute appendicitis. Materials and Methods: Present study was carried out in a tertiary care hospital over a period of two years. All patients were admitted in the emergency care unit as per hospital protocols. Patients were divided into two groups (Perforated and non-perforated). Patients found eligible as per inclusion and exclusion criteria were included. Results: 150 cases were studied with median age being 35 years. Male preponderance was noted. Symptom duration was higher in perforated appendicitis. Patients with perforated appendix had high Alvarado score. Appendicectomy was the most common surgical procedure. Probe tenderness was seen in maximum patients. Extraluminal air and periappendiceal inflammation were statistically significant predictors for appendiceal perforation. Conclusion: Patients with longer duration of pain have higher incidence of perforation. Alvarado score can predict the likelihood of perforation. Hospital stay is more in cases of perforated appendix. Antibiotic sensitivity should be considered when change of antibiotic is contemplated.