Frequency of Normal Appendicectomy in a Tertiary Care Hospital

Abstract

Objective: To determine the frequency of normal appendicectomy in a tertiary care hospital. 
Study Design: Prospective observational study. 
Place and Duration of Study: This study was carried out in Surgical Unit-I, Liaquat University Hospital 
Hyderabad, from Oct 2010 to Oct 2011. 
Materials and Methods: This study consisted of hundred patients admitted through the outpatient department, as 
well as from casualty department of Liaquat University Hospital Jamshoro/Hyderabad. Detailed History was taken 
from all the patients with special regard to the Pain in RIF, Pain starting around umbilicus, nausea, vomiting , fever 
and Altered bowel habits. Detailed Clinical examination of the patient was done .Site of right iliac fossa was 
especially examined for assessment of  tenderness and recorded in proforma. Systemic review was also done to see 
any co-morbidity. All patients underwent  base line and specific investigations especially ultrasound of abdomen as 
diagnostic modality for assessment of acute appendicitis. Inclusion criteria were all these patients who after 
counseling for this study and gave written consent. Irrespective of their age and sex admitted in Surgical Unit-I 
through outpatient department/ casualty and diagnosed as case of acute appendicitis. Exclusion criteria included all 
patients with features of generalized peritonitis, patients with palpable mass in right iliac fossa and patients with 
history of previous operation on lower abdomen. Follow up of all these patients was done. Results were prepared 
with help of tables and graphs. Data was analyzed through SPSS software. 
Results: Out of 100 patients included in this study 64 were male (64%) and 36 patients were female (36%); with 
male to female ratio of 1.7:1. There was wide variation of age ranging from a minimum of 10 year to 70 year. The 
mean age was 26.78 year. Symptoms of patients were pain in RIF in 99 (99%), pain starting around umbilicus in 42 
(42%), nausea in 65 (65%), vomiting 52 (52%), fever in 35 (35%) and altered bowel habits in 18 (18%). Clinical 
examination of patients revealed tenderness at Mc Burney’s point in 99 (99%) patients, while guarding was present 
in 80(80%) patients, rebound tenderness was present in 84(84%) patients and 33 (33%) patients had fever. 
Ultrasonographic findings revealed Wall thickness of appendix in 58(58%) patients where as normal appendix in 
42(42%) patients, Free fluid in the R.I.F and pelvis was found in 36(36%) patients, Thickening of the surround 
intestinal lobes was seen in 40(40%) patients and Mass of abscess formation in 8(8%) patients. Operative and 
histopathological findings were acute appendicitis in 59(59%) patients where as normal appendix in 21(21%) 
patients, adherent to bowel or omentum was found in 7(7%) patients, pus was seen in 5(5%) patients and perforated 
3(3%) patients. 
Conclusion:- In conclusion, we found 21 % of appendices to be histopathologically normal after emergency 
appendicectomies performed in this hospital. There was no mortality.