Hansson LE, Laurell H, Gunnarsson U. Impact of time in the development of acute appendicitis.
Dig Surg 2008;
25:394-9. [PMID:
19065056 DOI:
10.1159/000180451]
[Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Accepted: 07/30/2008] [Indexed: 12/12/2022]
Abstract
BACKGROUND
The aim of this study was to elucidate the natural history of appendicitis.
METHODS
Data was collected prospectively from consecutive patients admitted to hospital for acute abdominal pain. The degree of appendiceal inflammation in relation to preoperative duration of pain was analysed.
RESULTS
The study comprised 253 patients operated on for acute appendicitis that could recall the onset of abdominal pain. There was a longer duration of pre-hospital pain in patients, irrespective of age, with perforated appendicitis compared to patients with phlegmonous or gangrenous appendicitis (p < 0.001). In the multivariate analysis, patient age and preoperative duration of pain were independent risk factors for perforation.
CONCLUSION
Patient delay in presentation is the predominant factor determining the incidence of complicated appendicitis, and this delay is not influenced by age or gender.
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