Acute appendicitis - diagnosis and treatment

Abstract

An analysis was made from the clinical charts of 524 patients admitted to the HUV from January 1st to December 31, 1983. Fifty-five of the patients were males; the highest percentage of patients with acute appendicitis was in the 10-19 age group. Enity is rare in both extremes of life. Computer analysis allowed information regarding variables according to the inflammatory phase of the disease. The most frequent symptoms and signs in the majority of patients were abdominal pain, nausea, vomiting, anorexia, and positive Blumberg's sign; 70% of patients had abnormal CBC counts. The percentage of unnecessary laparotomies was 4.4%, and in 5 patients in whom the surgeon thought that the appendix was normal, pathological examination revealed acute appendicitis. The appendix was removed from the study of 524 patients. Pre and postop antibiotics were used in all patients with perforation, and the most frequent combination was gentamycin and chloramphenicol. There was only a 5% incidence of peritoneal cavity drainage. The majority of patients with complicated acute appendicitis were left with the skin incision opened to avoid severe wound infection. The bacterium most commonly isolated was Escherichia coli. We do not routinely perform anaerobic cultures at the HUV. The septic complications were the most frequent ones. The overall mortality rate was 1.5%