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The diagnostic challenge of postoperative acute appendicitis
D Barr1, J A van Heerden, P Mucha
1Section of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minnesota 55905.
World Journal of Surgery
|July 11, 1991
Summary
Acute appendicitis can occur post-operatively, presenting similar symptoms to classical appendicitis. Early diagnosis and intervention are crucial to prevent severe complications like perforation and abscesses.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Post-operative acute appendicitis is a rare complication.
- Understanding its incidence and clinical presentation is important for timely diagnosis.
Observation:
- A 10-year study (1979-1989) identified 0.1% of acute appendicitis cases occurring post-operatively.
- Symptoms mimicked classical appendicitis, with a mean latency of 14 days post-primary surgery.
Findings:
- Appendicitis occurred 5-31 days after initial operations.
- Patients presented with varied severity, including perforation (3 cases) and suppurative appendicitis (1 case).
- Complications included hepatic abscesses, septic shock, and prolonged ileus, but no mortality.
Implications:
- Post-operative appendicitis requires a high index of suspicion.
- Prompt surgical intervention is vital to mitigate morbidity associated with this condition.