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INTRODUCTION: Acute appendicitis remains a common surgical condition and the importance of specific elements in the clinical diagnosis remain controversial. A variety of neoplastic and inflammatory conditions mimic acute appendicitis. The purpose of this study was to determine the presenting pattern of acute appendicitis and to correlate with the pathological diagnosis. OBJECTIVE: This study was performed to determine and correlate between the clinical and per–operative pathological findings of acute appendicitis. MATERIALS AND METHODS: This is a retrospective analysis of 108 patients who had appendicectomy for acute appendicitis at Dhanalakshmi Srinivasan Medical College & Hospital, a tertiary care hospital in Rural area, Perambalur, Tamil Nadu during the periodApril 2017 to March 2018 (1 Year). Patient demographics,clinical features, operative findings and histology results were recorded on a special patient proforma. Study Type: Retrospective Study. Duration of the study: April 2017 to March 2018 (1Year) RESULTS: Out of the total of 108 patients studied, 66 were males i.e. 61.1% while 42 were femalesi.e.38.9%, with a male female ratio of 1.57:1. The majority of our patients were in the second decade (n=35 i.e. 32.4%). The most common presenting complaints were abdominal pain (n=108 i.e.100%), Nausea(n=57 i.e. 52.8%), vomiting (n= 84 i.e. 77.8%) and diarrhoea (n=9 i.e.8.3%). As for clinical signs 100% of the patients (n=108) in this study had some degree of right iliac fossa tenderness. At surgery, 67.6% (n=73) of appendices were apparently inflamed. 1.9% (n=2) were perforated and 4.6% (n=5) had appendicular abscess whereas in 25.9% (n=28) cases faecolith with inflammation was present. 67.6% (n=73) of the patients presented within 24 hours of the onset of symptoms. In 59.3% (n=64) of the patients Oral fluids were started on 1st post–operative day (POD). 56.5% (n=61) of the patients were discharged on the 5th day.
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Background: Appendicitis is the most commonly performed emergency abdominal surgery. An accurate and timely diagnosis of acute appendicitis remains a challenge. Objective: This study was performed to determine and correlate between the clinical patterns of acute appendicitis, laboratory and ultrasound findings and pathology found in appendicectomy specimens to help timely diagnosis and reduce negative appendicectomy rate. Methods: This is a cross sectional study, detailed history and clinical examination of the patient was carried out at the time of admission. Operative findings along with any complications as well as histopathological findings were recorded. Patients were followed up for one month for any complications. Results: A total of 125 patients were treated for appendicitis during this period with a male female ratio of 1:1.36. Most common age group was the 2nd decade with mean age being 20 years, while most common symptom was abdominal pain. Ultrasonography showed evidence of acute appendicitis in 85.6% and leucocytosis in 66.4% cases. Although only 5.6% of appendices grossly appeared normal during surgery, histopathology showed 14.4% to be normal. Wound sepsis (24.8%) was the most common post-operative complication. Conclusion: Diagnosis of acute appendicitis in our setting is still based on high index of suspicion following clinical evaluation. Combining this with laboratory findings and ultrasound scan has yielded an acceptable negative appendicectomy rate. We advocate routine use of ultrasound along with clinical evaluation and laboratory tests for the timely diagnosis of acute appendicitis and an early surgical intervention to prevent complications.