Acute appendicitis: a clinical pattern in Port Harcourt Nigeria

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Appendicitis diagnosis traditionally involves clinical signs and laboratory tests.
• Distinguishing between simple and complicated appendicitis is crucial for patient outcomes.

Purpose of the Study:

• To evaluate diagnostic criteria for appendicitis, focusing on the role of white blood cell count.
• To analyze outcomes and mortality rates in patients with simple versus complicated appendicitis.

Main Methods:

• Retrospective analysis of 201 appendicitis cases (152 simple, 49 complicated).
• Diagnosis of simple appendicitis based on symptoms and rebound tenderness, excluding white blood cell count.
• Comparison of white blood cell counts and mortality rates between simple and complicated appendicitis groups.

Main Results:

• 80.3% of simple appendicitis cases had normal white blood cell counts.
• Elevated white blood cell counts were present in 85.7% of complicated appendicitis cases.
• No mortality occurred in simple appendicitis cases; 12.2% mortality in complicated cases, contributing to a 3% overall mortality.

Conclusions:

• Clinical symptoms and rebound tenderness are key for diagnosing simple appendicitis.
• Complicated appendicitis outcomes are significantly worse, often linked to pre-admission factors like delays and cathartic use.
• White blood cell count is less reliable for simple appendicitis diagnosis compared to clinical presentation.