Acute appendicitis in a developing country.

World Journal of Surgery
Victor Y KongD L Clarke

Abstract

This prospective audit of appendicitis at a busy regional hospital reviews the spectrum and outcome of acute appendicitis in rural and peri-urban South Africa. We conducted a prospective audit from September 2010 to September 2011 at Edendale Hospital in Pietermaritzburg, South Africa. Over the year under review, a total of 200 patients with a provisional diagnosis of acute appendicitis were operated on at Edendale Hospital. There were 128 males (64 %) in this cohort. The mean duration of illness prior to seeking medical attention was 3.7 days. Surgical access was by a midline laparotomy in 62.5 % and by a Lanz incision in 35.5 %. Two percent of patients underwent a laparoscopic appendicectomy. The operative findings were as follows: macroscopic inflammation of the appendix without perforation in 35.5 % (71/200) and perforation of the appendix in 57 % (114/200). Of the perforated appendices, 44 % (51/114) were associated with localised intra-abdominal contamination and 55 % (63/114) had generalised four-quadrant soiling. Thirty percent (60/200) required temporary abdominal closure (TAC) with planned repeat operation. Major complications included hospital-acquired pneumonia in 12.5 % (25/200), wound dehiscence in 7 % (14/200), a...Continue Reading

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