Complicated appendicitis: experience from central region of Ghana (original) (raw)
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Acute Appendicitis: Incidence and Management in Nigeria
GUT, 2008
Appendicitis is the leading cause of surgical emergency admission in most hospitals in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life. Majority of patients in Nigeria present late with complicated disease. Surgery is the treatment of choice for appendicitis. However, patients must be adequately resuscitated before the procedure. Prognosis is excellent. High morbidities and occasional mortalities seen are usually due to late presentation and delay in treatments. Fear of surgery and cost of treatment are the main reason for late presentation. Mass education should be done to enlighten the populace on the evil of late presentation. The government should be implored to make widely available social support facilities that patients can make use of, at least in emergency situations.
Acute Appendicitis in a Developing Country
World Journal of Surgery, 2012
Background This prospective audit of appendicitis at a busy regional hospital reviews the spectrum and outcome of acute appendicitis in rural and peri-urban South Africa. Method We conducted a prospective audit from September 2010 to September 2011 at Edendale Hospital in Pietermaritzburg, South Africa. Results Over the year under review, a total of 200 patients with a provisional diagnosis of acute appendicitis were operated on at Edendale Hospital. There were 128 males (64 %) in this cohort. The mean duration of illness prior to seeking medical attention was 3.7 days. Surgical access was by a midline laparotomy in 62.5 % and by a Lanz incision in 35.5 %. Two percent of patients underwent a laparoscopic appendicectomy. The operative findings were as follows: macroscopic inflammation of the appendix without perforation in 35.5 % (71/200) and perforation of the appendix in 57 % (114/200). Of the perforated appendices, 44 % (51/114) were associated with localised intra-abdominal contamination and 55 % (63/ 114) had generalised four-quadrant soiling. Thirty percent (60/200) required temporary abdominal closure (TAC) with planned repeat operation. Major complications included hospital-acquired pneumonia in 12.5 % (25/200), wound dehiscence in 7 % (14/200), and renal failure in 3 % (6/200). Postoperatively 89.5 % (179/200) were admitted directly to the general wards, while 11 % (21/ 200) required admission to the intensive care unit. The overall mortality rate was 2 % (4/200).
CURRENT TRENDS OF ACUTE APPENDICITIS IN AFRICA: A CLINICAL REVIEW
International Journal of Healthcare Sciences , 2020
BACKGROUND: Appendicitis remains an intriguing disease entity, and there are severe unresolved postulations in the mind of clinicians worldwide. The primary concern is the likelihood of progression to perforation and the potential implications in contemporary African settings. A systematic review study has not been carried out for appendicitis research in Africa. AIM: To examine the literature critically and to present an update on current controversies on acute appendicitis with some particular emphasis on contemporary African settings. METHOD: A review of publications obtained from Medline search, medical libraries, and Google. RESULTS: Twenty-four audits were included in the quantitative analysis. Some were excluded from the subgroup analyses. Negative appendicectomies occurred at a rate of 18 % (488/3 862). Women were more likely to have a negative appendicectomy than men (32% versus 12%, p < 0.02). The perforation rate for appendicectomy patients was 28% (880/3 480), and the mortality rate was 3% (522/3 454). The current global research efforts are focused on the role of 'antibiotics' in the treatment and genetics of acute appendicitis CONCLUSION: Appendicitis remains a significant health challenge in Africa due to the attendant high incidence of perforations and complications. The current trend suggests that a nonsurgical, antibiotic approach in the treatment of uncomplicated appendicitis may be beneficial but remains 'controversial' with very low acceptance in Africa. This article reviews the current 'state of the art' in the evaluation and management of appendicitis that is leading to stratified care for patients, mainly in contemporary African settings.
Acute appendicitis in the developing world is a morbid disease
Annals of The Royal College of Surgeons of England
ABSTRACT INTRODUCTION Acute appendicitis in the developing world has a markedly different disease profile to that in the developed world. METHODS A retrospective study was undertaken over a four-year period at a university hospital in South Africa to review the disease spectrum and the clinical outcome of acute appendicitis. RESULTS A total of 1,004 patients (54% male, median age: 18 years) with intraoperatively confirmed appendicitis were reviewed. Over half (56%) were from the urban district within the city of Pietermaritzburg and the remaining 44% were from the rural health district. The median duration of illness from onset to definitive care was 4 days. Sixty per cent of appendices were perforated and associated with intra-abdominal contamination. Forty per cent of patients required reoperation to control intra-abdominal sepsis. Ten per cent required admission to the intensive care unit. The median overall length of hospital stay was 5 days. The mortality rate was 1%. Rural pat...
2019
Introduction- Acute abdomen is a sudden onset abdominal disease condition which often requires an immediate surgical intervention. Appendicitis is an inflammation of the vermiform appendix and is one of the most common causes of an acute abdomen in young adults. Appendicitis can cause severe periumbilical pain that radiates to the right lower quadrant, nausea, vomiting and anorexia. If left untreated, it can also cause appendiceal abscess, perforation and peritonitis. Objective - To assess treatment outcomes of Acute Appendicitis and associated factors among admitted patients with a diagnosis of acute abdomen in Debre Markos referral hospital from September 11/2018 to March 9/2019. Methods and materials - Institutional based cross sectional study was employed among 169 patients using a census sampling method. Data were collected from patient medical records, registration books and anesthesia charts available in the hospital by using checklist. Data was entered using Epi-data version...
Acute Appendicitis: Epidemio-Clinical and Therapeutic Aspects in Koutiala, Mali
Surgical Science, 2020
Purpose: To assess the epidemiological, clinical and therapeutic aspects of acute appendicitis at the Koutiala Reference Health Centre. Methods: This was a prospective study conducted in the general surgery department of the Koutiala Reference Health Centre. Patient records admitted for simple and complicated appendicitis during the period from August 1, 2017 to August 31, 2018 have been collected. Patients operated on for simple and complicated acute appendicitis were included in the study. Patients who did not have surgery were excluded. Results: We collected records of 62 patients who had surgery for simple and complicated acute appendicitis. They accounted for 11.9% of surgical procedures (n-520) and 27.3% (n-227) of surgical emergencies. The average age was 33.1 years-15.7. Men were in the majority with 72.5%. Simple acute appendicitis accounted for 56.4% of cases (n-35) and complicated appendicitis 43.6% of cases (these were 16 cases of appendicular peritonitis, 09 cases of appendicular abscess and 02 cases of appendicular plastron). Therapeutically, appendectomy was performed in 58 patients. In 4 patients the appendix was completely necrotized. The average length of hospitalization was 3.3 days-0.8 for single acute appendicites and 6 days-2.7 for complicated appendicites. Postoperative morbidity of complicated appendicitis was 6.4% (no. 4) and mortality was zero. Conclusion: Simple acute appendicitis is more common. Laparotomy remains the only way at present. Postoperative morbidity is high in complicated appendicitis and mortality is zero.
The Changing Spectrum of Acute Appendicitis in Nigeria: A Systematic Review
Appendicitis is one of the leading causes of general surgical emergency admission worldwide. Available clinical research has produced conflicting reports about best practice, delivery and, a possible variation in outcome in the sub-Saharan Africa. Accordingly, the disease represents an important burden on modern health systems with severe emerging atypical presentations. So far, there has not been any systematic review of the literature on appendicitis research in Nigeria.
Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases
World journal of gastrointestinal surgery, 2016
To investigate the epidemiology, treatment and outcomes of acute appendicitis (AA) in a large population study. This is a retrospective cohort study derived from the administrative dataset of the Bergamo district healthcare system (more than 1 million inhabitants) from 1997 to 2013. Data about treatment, surgery, length of stay were collected. Moreover for each patients were registered data about relapse of appendicitis and hospital admission due to intestinal obstruction. From 1997 to 2013 in the Bergamo district we collected 16544 cases of AA, with a crude incidence rate of 89/100000 inhabitants per year; mean age was 24.51 ± 16.17, 54.7% were male and the mean Charlson's comorbidity index was 0.32 ± 0.92. Mortality was < 0.0001%. Appendectomy was performed in 94.7% of the patients and the mean length of stay was 5.08 ± 2.88 d; the cumulative hospital stay was 5.19 ± 3.36 d and 1.2% of patients had at least one further hospitalization due intestinal occlusion. Laparoscopic ...