Optimizing Clinical Outcomes of Acute Appendicitis

Abstract

Background: Appendectomy is a common emergency procedure in general surgery. The objective of this study was to identify factors that impact on outcomes following appendectomy for acute appendicitis. Methodology: A chart review of all patients with a diagnosis of acute appendicitis who underwent appendectomy at Aga Khan University Hospital between January 2018 and December 2019 was performed. Results: Most of the patients (male-tofemale ratio, 2:1; mean age, 35±15.6 years) presented with acute uncomplicated appendicitis within an average of 2.98 days from symptom onset. The most common clinical sign was right lower quadrant tenderness. Abdominal ultrasound had a low sensitivity (33%), but computed tomography of the abdomen, which is the preferred imaging modality, had a high sensitivity (93%). The overall complication rate was 10.9%, with no statistically significant difference between open and laparoscopic appendectomy in terms of duration of surgery, length of hospital stay, and complication rates. The negative appendectomy rate was 6%. Conclusion: The complication rates of acute appendicitis in this setting are within international rates, but the negative appendectomy rate remains high. A more accurate interpretation of available imaging modalities is needed to improve this rate.