A CLINICAL STUDY ON DIAGNOSTIC AND CLINICOPATHOLOGICAL CORRELATION OF ACUTE APPENDICITIS UNDERGOING EMERGENCY APPENDICECTOMY IN A RURAL TERTIARY CARE HOSPITAL.

Dr.P.Kamalam; Dr.R.BalaMuralee; Dr.N.Lakshmi Priya

Volume : VIII, Issue : IX, September - 2018

A CLINICAL STUDY ON DIAGNOSTIC AND CLINICOPATHOLOGICAL CORRELATION OF ACUTE APPENDICITIS UNDERGOING EMERGENCY APPENDICECTOMY IN A RURAL TERTIARY CARE HOSPITAL.

Dr. P. Kamalam, Dr. R. Balamuralee, Dr. N. Lakshmi Priya

Abstract :

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.

CONCLUSION:

A diagnosis of acute appendicitis obvious based on strongly positive clinical signs. Present study shows that acute appendicitis in India is a disease of young males. On further sub–classification of acute appendicitis, uncomplicated acute appendicitis seems to be the most common. Delayed presentation is associated with greater morbidity