Appendicitis among African patients at King Edward VIII Hospital, Durban, South Africa: a review.

This retrospective study of 645 black patients, carried out over a five year period, showed that appendicitis is twice as common in males as in females and that it occurs predominantly in young people (median age 20 years). The classical presentation of periumbilical pain (16%) was outnumbered by right iliac fossa pain (36%) and non-specific pain (27%). The majority perforated (43%) and appendiceal inflammation was second commonest (37%). The negative appendicectomy rate was 8.8% and there was a diagnostic error of 14%. Mortality was two per cent mainly from patients complicated by peritonitis. Hospital stay was 7 +/- 7 days, with the longest stay following peritonitis. A diagnosis of appendicitis should always be entertained in an African patient presenting with an acute abdomen and, where the diagnosis is in doubt, a laparotomy should be performed.