Clinical and laboratory findings in patients subjected to laparotomy for suspected acute appendicitis

In a retrospective study, clinical and laboratory findings in 454 patients subjected to laparotomy for suspected acute appendicitis were evaluated. A normal appendix was found in 25% of the total series and was twice as common in female as in male patients. Perforated appendicitis was present in 8% of the series, most commonly in the youngest (less than 5 years) and the oldest (greater than 40 years) age groups. The incidence of severe appendicitis increased with the duration of the preoperative abdominal symptoms. Of the patients with a 'laboratory profile' including fever and leukocytosis, 44% had gangrenous or perferated appendicitis. Of those who additionally had elevated ESR (greater than 20 mm), 62% showed a gangernous or perforated appendicitis. The overall incidence of wound infection was 13.9%. Wound infection was closely related to the state of the appendix. The results thus indicated that patient's age, duration of abdominal symptoms and the 'laboratory profile' are important parameters for assessment of clinically suspected acute appendicitis.