Balogun Olanrewaju Samuel, Osinowo Adedapo, Afolayan Michael, Olajide Thomas, Lawal Abdulrazzak, Adesanya Adedoyin
Department of Surgery, Faculty of Clinical Sciences, College of Medicine, General Surgery Unit, University of Lagos, Idi-Araba, Lagos, Nigeria.
Department of Surgery, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
Ann Afr Med. 2019 Jan-Mar;18(1):36-41. doi: 10.4103/aam.aam_11_18.
Acute perforation of the appendix is one of the complications of appendicitis that is associated with increased morbidity and mortality and hence regarded as a surgical emergency. Risk factors for perforated appencidicits include extremes of age, male sex, pregnancy, immunosuppression, comorbid medical conditions and previous abdominal surgery.
This study focuses on the pattern of presentation, risk factors, morbidity and mortality of patients managed for perforated appendicitis in our centre.
We conducted a seven-year retrospective review of consecutive adult patients who had surgery for perforated appendicitis in our centre.
The perforation rate in the study was 28.5%. The peak age of presentation was between 21-30 years. Forty-two (71.1%) of the patients under study were males. Only 3 (5.1%) of the cohorts had history of recurrent abdominal pain. Majority of the patients were in the American Society of Anesthesiologists (ASA) II (44.1%) and III (42.4%) categories. Surgical site infections (SSI) (18.6%), wound dehiscence (15.2%) and pelvic abscess (13.5%) were the most common complications. The Incidence of SSI was found to correlate with male gender, (P = 0.041), co-morbidity (P = 0.037) and ASA score (0.03) at 95% confidence interval. Routine use of intraperitoneal drain after surgery for perforated appendicitis did not appear to reduce the incidence of pelvic abscess. No mortality in the studied population.
Appendiceal perforation was more common in male patients with first episode of acute appendicitis. Previous abdominal surgery and comorbid medical conditions were of lesser risk factors for appendiceal perforation in our patients. Surgical site infection was the commonest complication after surgery.
阑尾急性穿孔是阑尾炎的并发症之一，与发病率和死亡率增加相关，因此被视为外科急症。穿孔性阑尾炎的危险因素包括年龄极端情况、男性、妊娠、免疫抑制、合并内科疾病和既往腹部手术史。
本研究聚焦于我院中心接受穿孔性阑尾炎治疗患者的临床表现模式、危险因素、发病率和死亡率。
我们对我院中心连续接受穿孔性阑尾炎手术的成年患者进行了为期七年的回顾性研究。
本研究中的穿孔率为28.5%。发病高峰年龄在21至30岁之间。研究中的患者有42例（71.1%）为男性。队列中只有3例（5.1%）有反复腹痛史。大多数患者属于美国麻醉医师协会（ASA）Ⅱ级（44.1%）和Ⅲ级（42.4%）。手术部位感染（SSI）（18.6%）、伤口裂开（15.2%）和盆腔脓肿（13.5%）是最常见的并发症。在95%置信区间发现SSI的发生率与男性性别（P = 0.041）、合并症（P = 0.037）和ASA评分（0.03）相关。穿孔性阑尾炎手术后常规使用腹腔引流似乎并未降低盆腔脓肿的发生率。研究人群中无死亡病例。
阑尾穿孔在首次发作急性阑尾炎的男性患者中更为常见。既往腹部手术和合并内科疾病在我们的患者中是阑尾穿孔的危险因素较小。手术部位感染是术后最常见的并发症。
