ABSTRACT

Acute appendicitis is one of the most common cause of acute abdomen with the peak incidence in early adulthood. After the obstruction of the lumen by different causes, progressive inflammation and distention leads to the necrosis and perforation of the appendix wall, is the pathogenesis widely accepted by surgeons. According to this pathogenesis, perforated appendicitis is the result of nontreated acute appendicitis. But according to an other opinion supported by few authors, perforated appendicitis is a different entity. In this study, our aim was to evaluate which of these two opinions was relevant to the clinical practice.

One hundred thity patients operated in our clinic during 15 months due to appendicitis were prospectively evaluated. The patients were divided in 2 groups; acute appendicitis (group 1) and perforated appendicitis (group 2). Demographical data, leukocyte count, , length of time between the onset of the symptoms and the surgery, radiological evaluation, length of hospital stay, morbidity and mortality were investigated. For statistical analysis, Student t test was performed.

There were 97 patients in group 1 and 33 patients in group 2. Leukocytosis was common in both groups, but it was not significant to predict the perforation of the appendix. The length of time between the onset of the symptoms and the surgery was significantly longer in group 2 (p=0.002). The length of hospital stay was more significantly longer in group 2 (1.63 days versus 3.37 days, p=0.0001).

The data of this study support widely accepted pathogenesis, which point out that perforated appendicitis is not a different entity, is a pathological result due to the progression of untreated acute appendicitis.

Keywords: acute appendicitis, perforated appendicitis, acute abdomen