Ali N, Aliyu S
Department of Surgery, College of Medical Sciences, University of Maiduguri, Nigeria.
Niger J Med. 2012 Apr-Jun;21(2):223-6.
Acute appendicitis and its complications is still the most common cause of acute abdominal pain that will require surgical intervention in most parts of the West African sub-region. This study is a review of our management and outcome of acute appendicitis in the University of Maiduguri Teaching Hospital [UMTH].
A retrospective and prospective audit of all patients with acute appendicitis seen and managed over an 8- year period [2002-2009 inclusive] in the UMTH is presented. Materials used included patients demographic variables, clinical presentation, laboratory data, operative findings and treatment outcome.
One thousand two hundred and fifty-seven patients were studied. These were 426 (33.9%) males and 831 (66.1%) females; a male to female ratio of 1:2. The mean age was 32.4 15.0 years. All the patients were admitted with abdominal pain that was initially located at the right iliac fossa in 480 (38.2%), periumbilical in 393 (31.3%) and diffused in 351(27.9%) patients. Vomiting 85.7%, fever 73.0% and anorexia 49.0% were the most frequent symptoms. The mean duration of illness was 72 hours. Right iliac fossa pain and tenderness were present in 1112 (88.46%) patients. The total white cell count was significantly raised (p < 0.05). All the patients had appendicectomy, 295 (23.47%) of the appendices were perforated at operation and 200 (15.9%) of the removed appendices had no histological evidence of inflammation. The complication rate was 36.2% and wound infection (28.30%) was the most common. The mean hospital stay was 3 days. There were 12 deaths; a mortality rate of 0.9%; mostly patients with ruptured appendix and peritonitis.
The diagnosis of appendicitis is clinical and supported by a raised total white cell count with neutrophilia. The negative appendicectomy rate of 15.9% falls below the range reported in other studies. More than a fifth of the appendices were perforated and mortality was low.
在西非次区域的大部分地区，急性阑尾炎及其并发症仍是需要手术干预的最常见急性腹痛病因。本研究回顾了迈杜古里大学教学医院（UMTH）对急性阑尾炎的治疗及结果。
对UMTH在8年期间（2002年至2009年）诊治的所有急性阑尾炎患者进行回顾性和前瞻性审计。所用资料包括患者的人口统计学变量、临床表现、实验室数据、手术所见及治疗结果。
共研究了1257例患者。其中男性426例（33.9%），女性831例（66.1%），男女比例为1:2。平均年龄为32.4±15.0岁。所有患者均因腹痛入院，最初位于右下腹的有480例（38.2%），位于脐周的有393例（31.3%），弥漫性腹痛的有351例（27.9%）。最常见的症状为呕吐（85.7%）、发热（73.0%）和厌食（49.0%）。平均病程为72小时。1112例（88.46%）患者有右下腹疼痛和压痛。白细胞总数显著升高（p<0.05）。所有患者均接受了阑尾切除术，术中发现295例（23.47%）阑尾穿孔，切除的阑尾中有200例（15.9%）无炎症组织学证据。并发症发生率为36.2%，伤口感染（28.30%）最为常见。平均住院时间为3天。有12例死亡，死亡率为0.9%；主要是阑尾破裂和腹膜炎患者。
阑尾炎的诊断依靠临床症状，并由白细胞总数升高伴中性粒细胞增多支持。15.9%的阴性阑尾切除率低于其他研究报道的范围。超过五分之一的阑尾穿孔，死亡率较低。
