Keywords : ACUTE APPENDICITIS
Basrah Journal of Surgery,
2018, Volume 24, Issue 2, Pages 8-13
Acute appendicitis is the most common cause of emergency abdominal surgery with an estimated lifetime prevalence of 7%–8%. Despite advances in diagnosis and treatment, it is still associated with morbidity (10%) and mortality (1%–5%).
This study was designed to investigate the results of WBC count, platelet distribution width and C-reactive protein values based on the pathology results in patients undergoing appendectomy with an early diagnosis of acute appendicitis.
This prospective cross sectional study was carried out in Basrah Teaching Hospital from the period 1st of September 2015 to 1st of June 2017, a total of 154 consecutive patients were enrolled in the study. All patients were admitted to the emergency department with history suggestive of acute appendicitis, blood tests were done for inflammatory markers in form of WBC, CRP and PDW, a period of 24 hours prior to surgery was accepted, histopathological data were used to assess inflammation of the appendix.
The majority of patients were males 61% while females were 39%, with age range between 14-46 years (mean 24.28 years). There was a correlation between WBC count and acute appendicitis(P value=0.004), with sensitivity range (53%-69%) and specificity range (25-89%), while positive predictive value (PPV) and negative predictive value (NPV) were 96% and 8% respectively. A significant correlation found between CRP and acute appendicitis (p value less than 0.0001) with sensitivity range (71%-85%), while specificity was (10%-74%) and PPV, NPV were 95% and 9% respectively. Regarding PDW, no correlation was found with acute appendicitis (p value=0.296) with sensitivity range (6%-16%) while specificity (17%-82%), PPV 78%, NPV 2%. There was significant correlation between inflammatory markers (WBC, CRP, PDW) and complication with a p value=0.0001, ruptured appendix and peri-appendicular abscess were the most common complications recorded, only 8(5.2%) patients had normal appendix after histopathological examination.
In conclusion, acute inflammatory markers play an important role in diagnosis of acute appendicitis along with history and physical examination.
Basrah Journal of Surgery,
2015, Volume 21, Issue 1, Pages 76-81
Acute appendicitis is still considered the most common cause of acute abdomen in young adult age group. Appendectomy is the most frequent urgent abdominal operation and often is the 1st major procedure performed by surgeons in training. This study aimed to find whether laparoscopic appendectomy is superior to open approach or not.
This study was done in Al-Mawanee General Hospital in Basrah, Iraq. One hundred and sixty seven patients were randomized into open appendectomy group (OA) and laparoscopic appendectomy group (LA). Different parameters were studied to find which approach is the best. The study showed longer operative time in the LA group, while there was no significant difference regarding the hospital stay, post-operative pain and post-operative complication.
In conclusion, laparoscopic appendectomy is not found to be superior to open appendectomy as there was no clear significant difference between them regarding the parameters used in this study.