Acute Appendicitis Research Paper
Acute appendicitis is the most common acute surgical abdominal emergency occurrence worldwide. It is most common between the ages of 10 and 20 years, but can affect any age. The male to female ratio is 1.4:1, and the lifetime risk is 8.6% for males and 6.7% for females1.
A perforated appendix is a complication of untreated acute appendicitis. Ischemic necrosis of portion of the appendiceal wall will lead to perforation. Fecoliths are responsible for the perforation in about 90% of cases, but there are other causes of luminal obstruction including seeds of fruits and vegetables, lymphoid hyperplasia, intestinal worms especially Ascaris, malignancy and foreign body2.
Perforation of the appendix is reported to be more common in the elderly …show more content…
The patient-related factors are reported in many clinical studies to constitute the main reason of delays, Although physician-related diagnostic and management delays have been also reported7.
Some clinical studies suggested a close relation between the level of inflammation or perforation and duration of inflammation8, however, there have been a lack of evidence based data on the progress of appendicitis in time, and it is not proven scientifically if the risk of perforation is related to the duration of inflammation or it is because of the patient related factors9.
Clinical studies had demonstrated that Computed tomography provides a high degree of sensitivity (95%) and specificity (95%) for diagnosing perforation, the reported specific findings on a CT scan that can lead to identifying a perforated appendix are: the presence of a localized right iliac fossa abscess or phlegmon, a clear demonstrable defect in the appendiceal wall, an extraluminal air locules or free intraperitoneal air, the presence of appendicolith outside the appendix or within the right iliac fossa abscess, an intraperitoneal leak of rectal contrast, and the presence of multiple appendicoliths in association with thickened appendix or periappendiceal inflammation. Ultrasound is reported to be less reliable than a contrast enhanced
A perforated appendix is a complication of untreated acute appendicitis. Ischemic necrosis of portion of the appendiceal wall will lead to perforation. Fecoliths are responsible for the perforation in about 90% of cases, but there are other causes of luminal obstruction including seeds of fruits and vegetables, lymphoid hyperplasia, intestinal worms especially Ascaris, malignancy and foreign body2.
Perforation of the appendix is reported to be more common in the elderly …show more content…
The patient-related factors are reported in many clinical studies to constitute the main reason of delays, Although physician-related diagnostic and management delays have been also reported7.
Some clinical studies suggested a close relation between the level of inflammation or perforation and duration of inflammation8, however, there have been a lack of evidence based data on the progress of appendicitis in time, and it is not proven scientifically if the risk of perforation is related to the duration of inflammation or it is because of the patient related factors9.
Clinical studies had demonstrated that Computed tomography provides a high degree of sensitivity (95%) and specificity (95%) for diagnosing perforation, the reported specific findings on a CT scan that can lead to identifying a perforated appendix are: the presence of a localized right iliac fossa abscess or phlegmon, a clear demonstrable defect in the appendiceal wall, an extraluminal air locules or free intraperitoneal air, the presence of appendicolith outside the appendix or within the right iliac fossa abscess, an intraperitoneal leak of rectal contrast, and the presence of multiple appendicoliths in association with thickened appendix or periappendiceal inflammation. Ultrasound is reported to be less reliable than a contrast enhanced