Acute appendicitis--a benign disease?

  • Simpson J
  • Samaraweera A
  • Sara R
 et al. 
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INTRODUCTION: 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. PATIENTS AND METHODS: Adult patients (> 16 years) undergoing an emergency appendicectomy at a University teaching hospital between February 2004 and January 2005 were identified from pathology records. Details of operative procedure, histology and postoperative complications were noted from the hospital case notes RESULTS: A total of 199 patients with a median age of 31 years (range, 16-89 years) were identified. Of these, 58 (29%) patients experienced a postoperative complication. Eight (4%) patients were admitted to the surgical high dependency unit or intensive care unit postoperatively and there was one death (0.5%). Re-operation for a postoperative complication was required in 9 (4.5%) patients and there was a 13% re-admission rate (26 patients). Comparison between patients with histologically proven appendicitis (164 patients; 82%) and those patients having a negative appendicectomy (35 patients; 18%) showed no significant difference in the rate of complications as defined (43 of 164, 26% versus 15 of 35, 43%; P = 0.08). However, patients with positive histology were more likely to experience a septic complication (29 of 164, 18% versus 1 of 35, 3%; P = 0.028) and all re-operations came from this group. Despite this, patients with a negative appendicectomy were more likely to be re-admitted (12 of 35, 34% versus 14 of 164, 8.5%; P = 0.0002), predominantly with persistent abdominal pain. CONCLUSIONS: Appendicectomy is associated with a significant morbidity. Patients with an inflamed appendix were more likely to experience a septic complication but re-admission was more common in patients with a histologically normal appendix because of unresolved abdominal pain.

Author-supplied keywords

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Appendectomy/*methods
  • Appendicitis/*surgery
  • Emergencies
  • Female
  • Humans
  • Intensive Care/statistics & numerical data
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Complications/*etiology/surgery
  • Preoperative Care/methods
  • Reoperation/statistics & numerical data
  • Treatment Outcome

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  • J Simpson

  • A P Samaraweera

  • R K Sara

  • D N Lobo

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