Lippert H, Detzner D
Zentralbl Chir. 1986;111(13):801-6.
Symptoms and clinical findings recorded from 379 patients (6.7 per cent of all cases of appendectomy) with perforated appendicitis, between 1970 and 1984, were retrospectively evaluated. Children up to 14 years of age accounted for 32.8 per cent, adults for 37.8 per cent, and adults above 50 years of age accounted for 30.2 per cent of the above group. More than three typical appendicitis symptoms were recordable from only 30 per cent of all patients. Decompressive and jolting pain was the most common clinical symptom and was recorded from 66.6 per cent of the above 379 patients. 50 per cent of the patients did not exhibit leucocytosis, and normal body temperatures were measured from 21.1 per cent in spite of perforated appendicitis. The event of perforation occurred both six hours after onset of complaints as well as four days later. Obesity, enteritis, and cardiovascular diseases were the most common diseases established in concomitance with perforated appendicitis. 9 patients (2.3 per cent) died of the consequences of peritonitis or accompanying diseases. In patients with suspected appendicitis it is not justified to delay surgery even in the presence of serious associated disease.
对1970年至1984年间379例(占所有阑尾切除术病例的6.7%)穿孔性阑尾炎患者记录的症状和临床发现进行了回顾性评估。14岁以下儿童占上述人群的32.8%,成年人占37.8%,50岁以上成年人占30.2%。在所有患者中,只有30%可记录到三种以上典型阑尾炎症状。减压性和颠簸性疼痛是最常见的临床症状,在上述379例患者中有66.6%记录到该症状。50%的患者未出现白细胞增多,尽管是穿孔性阑尾炎,但仍有21.1%的患者体温正常。穿孔事件在主诉出现后6小时以及4天后均有发生。肥胖、肠炎和心血管疾病是与穿孔性阑尾炎并发的最常见疾病。9例患者(2.3%)死于腹膜炎或伴发疾病的后果。对于疑似阑尾炎患者,即使存在严重的伴发疾病,延迟手术也是不合理的。