Perforating appendicitis. A nine-year survey of treatment and results

This is a clinical study of 193 adult cases of perforating appendicitis during a nine-year period of treatment. There were 77 females (39.9%) and 116 males (60.1%) with ages of 15 years and above. Throughout the study period, the yearly perforation frequency ranged from 10.0 to 23.1% (mean 16.7%) of all cases with proven appendicitis. Perforation was equally common in both sexes, females: 15.5%, males: 17.6% of the appendicitis cases. In elderly patients (greater than or equal to 60 years of age) perforation was much more common; 37 out of 77 cases with proven appendicitis (48.1%). Compared to different ages (patients under and above 60 years of age), clinical and laboratory findings were found equal. Duration of symptoms showed no differences for younger and elderly patients. Preoperative delay in the hospital of at least 6 hours occurred in 39.9% of all patients, and was found equally common in patients younger than 60 years (39.1%) and in those from 60 years and older (43.2%). There were no fatalities in the study group. Postoperative septical complications predominated over non-septical (32.6 versus 9.3%), and were equally common in both sexes and in patients of different ages. The frequency of occurrence of septical complications was not significantly influenced by the duration of symptoms or by the duration of operation, furthermore, septical complications were equally frequent throughout the study period, although the use of antibiotics changed towards drugs more potent to cover anaerobic bacteria (28.1% infections for the period 1972-1976 versus 29.8% for the period 1977-1981).(ABSTRACT TRUNCATED AT 250 WORDS)