Complicated appendicitis: experience from central region of Ghana

Abstract

Background: Acute appendicitis is a common surgical abdominal emergency. The aim of this study is to determine the incidence, presentation and immediate outcome of acute appendicitis in a new teaching hospital in Cape Coast. Methods: All patients who had surgery for acute appendicitis at the central regional Hospital, cape coast from 1st January 2011 to 25th October 2012 were retrospectively reviewed. Results: During the study period five hundred and four emergency surgical operations were performed. Abdominal emergency operations constituted 81.5% of these emergencies (411/504). Seventy-seven patients who had appendicectomy during the period constituted 18.7% of all abdominal emergencies. Seventy-six of the patients had requisite details for analysis and form the basis of this study. Appendicitis was seen more in the second and third decades of life with male preponderance. Thirty-one (40.3%) had complicated appendicitis (perforated/ ruptured appendicitis and gangrenous appendix). Though appendicitis is uncommon in children less than ten years, more than 80% presented with complicated appendicitis. Only 6.6% of patients were 50 years and above and they all presented with complicated appendicitis. In male patient with appendicitis, 33.3% presented with complicated appendicitis while in females, 57.9% presented with complicated appendicitis. Two (2.6%) patients died in the immediate postoperative period. Conclusions: About one out of five patients who had emergency abdominal surgical operation had acute appendicitis with 40% of them presenting with complicated appendicitis. Complicated appendicitis is more common in females, children less than 10 years and patients 50 years and above. Immediate postoperative mortality is associated with ruptured appendix.