Acute appendicitis: experience in a tertiary care hospital of Peshawar

ABSTRACT

To study the patients' characteristics and predominant clinical features in patients with acute appendicitis in a teaching hospital. A cohort study. Surgical department, Khyber Teaching Hospital Peshawar [Pakistan], from August 2005 to August 2006. Convenient sampling. A total of 72 patients with established diagnosis of acute appendicitis were included in the study. The age range of the patients was from 11 years to 57 years. Relevant information was recorded from patients and treatment chart of the patients on a questionnaire designed in accordance with the objectives of the study. Out of a total of 72 patients. 46 [63.89%] patients were males and 26 [36.11%] were females, with a male to female ratio of 1.71. Chief complaints were colicky abdominal pain [91.66], nausea and vomiting [73.61%], anorexia [76.38] and fever [59.12%]. On examination the findings recorded were abdominal tenderness [83.33], rebound tenderness [75], pyrexia low grade [59.12], pulse rate more than 80 [54.16], guarding [58.33], positive revising sign [43.05], positive psoas sign [13.88], and positive obturator sign [8.33]. The Alvarado score [AS] was studied in all patients to support the diagnosis. Out of total, 52.77% had AS<4 [Group III], 40.25% had AS 5-7[Group II] and 6.94% with AS>7/10 [Group I]. We observed that acute appendicitis is more commonly seen in the upper social class people [62.5%] in our setup. Acute appendicitis was more commonly observed in younger age. The classical signs of the disease are not always present, however, the scoring systems [like Alvarado scoring system] and laboratory investigations improve the diagnostic accuracy