[Morbidity and mortality of appendicitis]

A retrospective analysis of the case histories of 238 patients who were hospitalized with acute appendicitis in the Clinical Hospital 60 of the Instituto Mexicano del Seguro Social from 1970 to 1971 revealed the following: 36% of the patients were operated in the earliest stage of acute appendicitis, 21.8% presented with perforated appendix and 32.6% with local and systemic septic complications. The group with perforated appendix presented most frequently with high levels of leucocytes and abscesses in incisions. All the cases of residual abscesses were found in this group and also two deaths were reported. It was interesting to find that routine drenage of the apendicectomy did in result in a decrease in local and systemic complications; in fact, they were found to be increased. Similarly it was found that the irrational use of antibiotics did not prevent abscess formation in the incision in the less seriously ill group and only served to confuse the clinical picture and impede the initiation of opportune treatment. Generally the diagnosis can be established from the clinical picture, but ocasionally it is necessary to operate in order to accurately evaluate the gravity of the lesion.