CURRENT GUIDELINES ON EVIDENCED-BASED DIAGNOSIS AND MANAGEMENT OF ACUTE APPENDICITIS

Abstract

Introduction: Appendicitis is the inflammation of the vermiform appendix.  Appendicitis can be considered the most commonly interpretive cause of acute and severe abdominal pain. Acute Appendicitis (AA) is mainly caused by luminal obstruction obstructed by numerous etiologies. This causes an increase in the rate of bacterial overgrowth and mucus production thereby causing necrosis, wall tension and potential perforation.

Materials and Methods: The study is a Retrospective cohort and was conducted during the periods of 11 months. The study included 97 patients with appendicitis and divided them based on the protocol by which they receive diagnosis and management. Out of 97 patients, 49 patients were assigned to group 1 and the other 48 patients were assigned to group 2. Group 1 includes those patients who were treated symptomatically and diagnosis and management were given to them according to the wish of the consulting physician. For the determination of outcomes of treatments given to Group 1 and Group 2 patients, the study considered complications found in the patients. These complications are recorded for each of the groups. Also, the study recorded the complication in each of the treatment methods of Group 1 patients. This allowed the authors of this study to find out how outcomes vary when treatment is given differently from that of Alvarado Scoring criteria.

Results: The complications that were found in the study participants are fever, generalized peritonitis, perforation, abscess, a mild respiratory infection. The study found that the complications among the patients in Group 1 and Group 2 separately. In Group 1, 8 patients had a fever, while 3 patients had a fever in Group 2. Group 1 patients had all the listed complications including perforation (n=7), abscess (n=4), mild respiratory infection (n=3) and peritonitis (n=2). In Group 2, only 4 patients showed complications including fever in 3 patients and perforation in 1 patient.

Conclusion: The study has concluded that following Alvarado criteria in diagnosis and management of acute appendicitis results in the least possible complications. The study suggests the clinicians follow Alvarado criteria for proper management of acute appendicitis.

Keywords: Acute appendicitis, Alvarado criteria, appenditis complications, appendicitis diagnosis, appendicitis treatment