Document Type : Original Article


1 Professor of Surgery and consultant surgeon CABS. FACS,Department Of Surgery, University Of Basrah, College Of Medicine, Basrah, Iraq

2 Sixth year medical student, Basrah College of Medicine. University of Basrah. Iraq



Appendicitis is a common surgical emergency with a global incidence of approximately 233 per 100,000 population. The incidence is higher in males than in females, and it varies across seasons and countries. This study aims to throw light on the pattern of appendicitis in Basrah. Iraq


This is a retrospective analysis of all available data in Basrah Teaching Hospital for the last 10 years covering the period from January 1999 to December 2008. The total number of hospital admissions for each year was obtained in addition to age, gender and month of admission for all the cases of appendicitis were recorded. Tables and figures were drawn and an analysis was done, using simple Chi square test, and P value as found appropriate.


There were 5412 patient underwent Appendectomy with M: F ratio as 3.4: 1. The overall mean age was 24.3 years. The highest incidence was in April, May, June, and July with a peak level in December. Ramadan (the fasting month) showed a significant increase in incidence of appendicitis


There is an increase incidence of acute appendicitis over the years with more prevalence in males and more common in the second decade of life for both males and females, also the incidence was higher in summer moths and in Ramadan.


Main Subjects

  1. Ben-David K, Sarosi GA Jr. Appendicitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Vol 2. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:2599-2612.


  1. Aneel Bhangu, Kjetil Søreide, Salomone Di Saverio, et al. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management Vol 386. September 26, 2015.


  1. Moris D, Paulson EK, Pappas TN. Diagnosis and management of acute appendicitis in adults: a review. JAMA. 2021; 326(22):2299-2311.


  1. Linjing Guan1†, Zhen Liu2†, Guangdong Pan2, et al. The global, regional, and national burden of appendicitis in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. BMC Gastroenterology (2023) 23:440.


  1. Ferris M, Quan S, Kaplan BS, et al. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies. Ann Surg. 2017;266(2):237-241.


  1. Weledji,Elroy. 2020. Appendicitis: Epidemiology,Evaluation, and Controversy in Management Elroy Patrick Weledji. Available at (Accessed :May 20, 2023)


  1. Oguntola AS, Adeoti ML, Oyemolade TA. Appendicitis: Trends in incidence, age, sex, and seasonal variations in South-Western Nigeria. Ann Afr Med 2010; 9:213-7.


  1. Mohammed Al-Omran, Muhammad M. Mamdani, Robin S. McLeod: Epidemiologic features of acute appendicitis in Ontario, Canada. Can J Surg, Vol. August 2003; 46, No. 4,


  1. Barlas Sulu,Yusuf Gunerhan, Baris Ozturk,Hsan Arslan: Is long- term(Ramadan model) a risk factor for acute appendicitis? Saudi Med J 2010; Vol. (1). 59-63.


  1. Seyed Mohammad Piri, Sahar Saeedi Moghaddam, Zahra Ghodsi, et al: Trend of Appendicitis Mortality at National and Provincial Levels in Iran from 1990 to 2015. Arch Iran Med. May 2020; 23(5):302-311.


  1. Osman AA. Epidemiological study of appendicitis in Khartoum. Int Surg 1974; 59; 218-23.


  1. Ghazi Qasaimeh, Ismail Ibrahim Matalka, Yousef Saleh Khader: Acute Appendicitis in North of Jordan - A 10 year survey. Jordan Medical Journal. December 2008.


  1. Haifa Aroui, Dalila Taieb, Imene Kacem: The effect of environmental factors on the incidence of perforated appendicitis. Ann Ital Chir - Epub Ahead of Print, 2018, 7 - July 23


  1. Martin DL, Gustafson TL. A cluster of true appendicitis cases. Am J Surg 1985; 150:554-7


  1. Walker AR, Walker BF, Le lake A, Manetsi B, Tlotetsi GT,Verardi MM, et al. Dietary fibre intake and chronic bowel diseases: Transit time in black and white adolescents in South Africa. S Afr J Food Sci Nutr 1994; 6:55-8.


  1. Alves JG, Figueiroa JN, Barros I. Does breast feeding provide protection against acute appendicitis? A case control study. Trop Doct 2008; 38:235-6.


  1. Räty S, Sand J, Alho H, Nordback I. Alcoholic, but not biliary, pancreatitis varies seasonally in occurrence. Scand J Gastroenterol 2003; 38:794-7.


  1. Robert E. Condon: Apendicitis. Davis C. Sabiston. Davis - Christopher Textbook of Surgery. B. Saunders Co. Asian Ed.1975; 925-940


  1. Fuller MY, Leino DG, Reyes-Múgica M, et al. Ingested Foreign Bodies Can Cause Appendicitis and Perforation: A Multi-Institutional Case Series. Pediatric and Developmental Pathology. 2022; 25(5):499-503.


  1. Freud E, Pilpel D, Mares AJ. Acute appendicitis in childhood in the Negev region: Some epidemiological observations over an 11-year period (1973-1983). J

Pediatr Gastroenterol Nutr 1988; 7:680-4.


  1. Luckmann R, Davis P. The epidemiology of acute appendicitis in California: Racial, gender, and seasonal variation. Epidemiology 1991; 2:323-30.


  1. Ashley DJ. Observations on the epidemiology of appendicitis. Gut 1967; 8:533-8.


  1. David G, Addiss NS, Barbara S, Fowler BS, Tauxe RV. The Epidemiology of

Appendicitis and Appendectomy in the United States. Am J Epidemiol. 1990; 132(5):910-25.


  1. Lee JH, Park YS, Choi JS. The Epidemiology of Appendicitis and Appendectomy in South Korea: National Registry Data. J Epidemiol.2010;20(2):97-10.


  1. David G, Addiss NS, Barbara S, Fowler BS, Tauxe RV. The Epidemiology of

Appendicitis and Appendectomy in the United States. Am J Epidemiol. 

1990; 132(5):910-25


  1. Kai-Biao Lin, K. Robert Lai, Nan-Ping Yang, et al: Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study. World Journal of Emergency Surgery (2015) 10:42.


  1. Noudeh YJ, Sadigh N, Ahmadnia AY. Epidemiologic features, seasonal variations and false positive rate of acute appendicitis in Shahr-e-Rey, Tehran. Int J Surg 2007:5:95-8.


  1. Ahmed W, Akhtar MS, Khan S. Seasonal variation of acute appendicitis. Pak J Med Sci. 2018; 34(3):564-567.


  1. Fares A. Summer appendicitis. Ann Med Health Sci Res 2014; 4:18-21.


  1. .Sulu B, Günerhan Y, Palanci Y, Işler B, Cağlayan K.Epidemiological and demographic features of appendicitis and influences of several environmental factors. Ulus Travma Acil Cerrahi Derg 2010; 16:38-42.


  1. Wei PL, Chen CS, Keller JJ, Lin HC. Monthly variation in acute appendicitis incidence: a 10-year nationwide population-based study. J Surg Res. 2012; 178(2):670-6.


  1. A. Davoodabadi, H. Akbari, Rasoulinejad: The Impact of Fasting during the Holy Month of Ramadan on Incidence of Acute Appendicitis. IJMS Vol 30, No 1, March 2005; 21-23