2024/07/10 by Modekwe, Victor, Ekwunife, Okechukwu, Ugwu, Jideofor Okechukwu +6
#abscess #acute appendicitis #complicated appendicitis #fever #outcome
paper · doi:10.60787/tnhj.v24i2.811
Background: The diagnosis of appendicitis has remained clinical. Available scoring systems do not differentiate the sub-types of the diagnoses and prognosticate the outcome. This study assessed the determinants of the sub-types of appendicitis and post-operative outcome. Method: A retrospective study of all cases of appendectomies in children aged 1 -18 years, from January 2012 to December 2020. Data was collected in a proforma, analysed with SPSS and presented in tables. Result: There are 100 cases of appendicitis with 57% males and 43% females. The mean age was 12.4(+3.35) years. The symptom onset- presentation interval ranged from 6 hours to 6years (median 5.5 days). Commonest symptoms were right iliac fossa pain - 80%, vomiting - 58%, fever – 52%, nausea – 39%, and anorexia - 35%. Commonest diagnosis and procedure were acute appendicitis-59% and emergency appendectomy-71.4%, respectively. The median presentation-surgery interval was 23hours. Complication rate was 18% with SSI accounting for 11%. There is a relationship between absence of fever and simple appendicitis (P < .001). There is also a relationship between absence fever and absence of post-op complications (P = .019). However, absence of fever is not a determinant of the sub-diagnosis of appendicitis or post-operative complication. Symptom duration of >48hrs is a determinant of post-operative complication (OR 18.4, P = 0.013, CI = 1.84 – 184.5). Conclusion: Normal temperature may suggest a simple appendicitis. Symptoms duration of >48hrs has at least 18-fold chance of post-operative complications.