Original article
English
Salma Elzwai, Musa Elgadi, Ali A. Sheba, Nourz A.Gheriani
Al-Fateh Hospital for Children, Benghazi, Libya
JMJ 2008,Vol.8, No.3:191-194
Abstract
Objective: To determine factors likely to be associated with risk of perforation, and to delineate some epidemiological features of acute appendicitis. Setting: Al- Fateh Children’s Hospital, Benghazi, Libya from January 2003 to March 2005. Patients and Methods: Medical records of patients who were diagnosed with acute appendicitis and underwent appendectomies were reviewed. Results: A total number of 441 patients were included in the study. Male to female ratio was 2.3:1 and 59.2% were between 10 and 14 years of age. No seasonal variation was noticed. Out of 441 patients, 122 patients had perforated appendicitis, estimating perforation rate of 27.7% , of them 82 patients presented later than 24 hours of onset of symptoms (delayed presentation) with P value of < 0.001, and 18 patients were initially misdiagnosed leading to perforation in all. Eight patients were misdiagnosed because of unusual presenting symptoms (constipation, limping, skin rash, and abdominal distension). Perforation rate was highest (55.5%) among patients less than 5 years of age. Eighteen percent of patients with perforated appendicitis suffered complications such as intestinal obstruction (6.6%), wound infection (3.3%) and intra-abdominal abscess (3.3%). Mortality rate was zero. Conclusion: Our patients have a high perforation rate and subsequently high complications. Delayed presentation is the main risk factor of perforation. Moreover, misdiagnosis is another important risk factor especially among children less than 5 years of age who require physicians with high index of suspicion. Perforation rate was more in male patients than females. In female the rate of normal appendix was higher than male patients. Age and gender distribution is similar to international distributions, but no seasonal variation was noted among our patients . Keywords: Acute appendicitis, Perforated appendicitis, Risk factors Link/DOI: http://www.jmj.org.ly/PDF/autumn2008/191.pdf