Diagnostic Value Of Bedside Evaluation In Patients Of Perforated Appendicitis

Abstract

Background

Acute appendicitis is one of the most common surgical condition which has to be treated on emergency basis worldwide. The perforated appendicitis and uncomplicated appendicitis are having almost same presentation, the signs and symptoms overlap so differentiating between the two is very important and is the topic of debate. Current study aimed to find out the differentiating signs and symptoms between uncomplicated appendicitis and the complicated appendicitis preoperatively.

Methods: 

A case control study was conducted at the surgical department of Sir Syed College of Medical Sciences for Girls during the period of July to December 2021. After getting permission from the hospital the medical record of all those patients who under wend open or laparoscopic appendectomy were collected. Study participants were divided into two groups; Group-I was having simply inflamed appendix while the Group-II including perforated appendicitis. Data was analyzed by using Statistical Package for Social Science version-20. p-value less than 0.05 was considered as statistically significant.

Results:

The mean age of the study participants in simple appendicitis was 22.8±8.7 years while in perforated appendicitis, it was 26.3±7.6 years. Total leukocyte count was higher in perforated appendicitis than the uncomplicated one. Few signs and symptoms showed strong significant association with inflammation and perforation of appendix, including diarrhea, generalized abdominal pain, right lumbar quadrant pain, anorexia, guarding in right iliac region and a palpable mass in right iliac fossa. Other symptoms like nausea, vomiting, upper abdominal pain, mid abdominal pain, lower abdominal pain, right lumbar quadrant pain, rebound tenderness, radiation, dysuria, malaise and fever, have found no any significant association.

Conclusion:

It can be concluded that the traditional bedside evaluation is a very good approach for diagnosing perforated appendicitis, specially focusing the parameters like diarrhea, generalized abdominal pain, right lumbar quadrant pain, anorexia, guarding in right iliac region and a palpable mass in right iliac fossa.