A Comparative Study of Perforated and Non-Perforated Appendicitis With Respect to Clinical and Laboratory Findings

Introduction:The vermiform appendix is considered by most to be a vestigial organ, its importance in surgery is only due to its tendency for inflammation resulting in the syndrome called acute appendicitis. Acute appendicitis is the most common cause of an “acute abdomen” in young adults. Appendectomy is the most frequently performed emergency abdominal operation. Present study was undertaken to study the clinical pattern of presentation and to analyze the difference in the anatomical, biochemical, microbiological, histological determinants in patients of perforated and non-perforated acute appendicitis. Materials and Methods:Present study was carried out in a tertiary care hospital over a period of two years. All patients were admitted in the emergency care unit as per hospital protocols. Patients were divided into two groups (Perforated and non-perforated). Patients found eligible as per inclusion and exclusion criteria were included. Results: 150 cases were studied with median age being 35 years. Male preponderance was noted. Symptom duration was higher in perforated appendicitis. Patients with perforated appendix had high Alvarado score. Appendicectomy was the most common surgical procedure. 81.33% had acute inflamed appendicitis. Incidence of gangrenous and suppurative appendicitis was higher in cases of perforated appendicitis. Conclusion: Patients with longer duration of pain have higher incidence of perforation. Alvarado score can predict the likelihood of perforation. Hospital stay is more in cases of perforated appendix. Antibiotic sensitivity should be considered when change of antibiotic is contemplated.