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Published on: August 24, 2019

ACUTE APPENDICITIS

E C WEINSTEIN

    California Medicine
    |June 1, 1965
    PubMed

    Insights

    Diagnosing acute appendicitis is challenging, with a 76% accuracy rate. Prompt surgical exploration is recommended for questionable cases to reduce morbidity from appendiceal perforation.

    Area of Science:

    • Gastroenterology
    • Surgical Pathology

    Background:

    • Acute appendicitis remains a significant cause of morbidity and mortality.
    • Diagnostic challenges in acute appendicitis can lead to delayed treatment or unnecessary surgeries.
    • Perforation significantly increases patient morbidity.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of acute appendicitis at Holy Cross Hospital.
    • To assess the morbidity associated with perforated versus non-perforated appendicitis.
    • To investigate characteristics of mesenteric lymphadenitis cases mistaken for appendicitis.

    Main Methods:

    • Retrospective review of 316 patients operated on for suspected acute appendicitis.
    • Analysis of diagnostic accuracy and perforation rates.
    • Review of 30 patients with mesenteric lymphadenitis who underwent surgery.

    Main Results:

    • Overall diagnostic accuracy for acute appendicitis was 76%.
    • Perforation occurred in 10.0% (24/239) of proven appendicitis cases, with threefold higher morbidity.
    • Mesenteric lymphadenitis, often misdiagnosed as appendicitis, predominantly affected young females with mild leukocytosis.

    Conclusions:

    • No clear diagnostic criteria were identified to predict appendiceal perforation.
    • The morbidity from unnecessary surgery for conditions like mesenteric lymphadenitis is substantially lower than from perforated appendicitis.
    • Prompt surgical exploration is warranted in clinically ambiguous cases to mitigate risks of perforation.

    Keywords:
    APPENDICITISDIAGNOSIS, DIFFERENTIALMORBIDITY

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