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Acute appendicitis--the University Hospital experience
H Y Lee1, P Jayalakshmi, S H Noori
1Department of Surgery, University Hospital, Kuala Lumpur.
The Medical Journal of Malaysia
|March 1, 1993
Summary
Delayed diagnosis of acute appendicitis significantly increases perforation risk, especially in older adults. Diagnostic errors were common across age groups, highlighting the need for improved diagnostic accuracy and timely surgical intervention.
Area of Science:
- Medical research
- Surgical outcomes
- Diagnostic accuracy
Background:
- Acute appendicitis is a common surgical emergency.
- Timely diagnosis and treatment are crucial to prevent complications like perforation.
Purpose of the Study:
- To review cases of acute appendicitis treated at a university hospital.
- To identify factors contributing to delayed diagnosis and diagnostic errors.
- To assess outcomes including perforation rates and waiting times for surgery.
Main Methods:
- Retrospective review of 529 acute appendicitis cases.
- Analysis of diagnostic accuracy, perforation rates, and treatment delays.
- Evaluation of patient demographics and diagnostic indicators.
Main Results:
- A perforation rate of 23.7% was observed.
- Significant delays in diagnosis were noted, particularly impacting patients over 50.
- Diagnostic error occurred in 19.3% of cases, affecting young women and children.
- Leukocytosis was a helpful diagnostic indicator, unlike temperature or rectal examinations.
- Median waiting time for surgery was 7 hours for all appendicitis cases.
Conclusions:
- Delayed diagnosis is a significant issue in acute appendicitis management.
- Older patients are at higher risk of perforation.
- Diagnostic errors necessitate improved clinical evaluation and diagnostic strategies.
- Long waiting times for surgery require attention to optimize patient care.