Incidence and Associated Factors of Negative Appendectomy in Kalasin Hospital

Abstract

Background and objective : Acute appendicitis is the most common emergency surgical condition. Early operation may reduce the complicated appendicitis but may increases incidence of negative appendectomy too. This study aims  to find out  negative appendectomy rate and clinical factors associated with negative appendectomy

Methods : Retrospective descriptive study at Department of surgery, Kalasin hospital.                     908 patients had diagnosed with acute appendicitis and underwent appendectomy from June 2007-December 2008 . Incidental appendectomy, interval appendectomy and patients under 7 years were excluded from the study. Medical records, operative notes and pathological reports of patients were reviewed. Age, gender, migratory pain , anorexia, vomiting, right lower quadrant pain and tender, fever and leucocytosis were studied.

Results : Appendicitis was diagnosed equally in male and female patients. Their mean age was 31.24+ 16.89 years old. Negative appendectomy rate of 14.0% was found. The female patients were more likely to be diagnosed  as  negative appendectomy than the male significantly (p<0.05). Factors related to negative appendectomy; female,no fever, no migratory pain, no anorexia, no nausea or vomiting, no guarding and tender at right lower quadrant and no leucocytosis, these were significant (p < 0.05).

Conclusion: The diagnosis of acute appendicitis is sometime difficult.To fine out associated factors related to negative appendectomy is useful to avoid missed diagnosis.

Keywords: Negative appendectomy, Acute appendicitis, Associated factors.