A case report of perforated appendicitis with pyoperitoneum in a tertiary care center

Abstract

Acute appendicitis remains one of the most frequent reasons for emergency hospital admissions and the most common cause of an 'acute abdomen' in young adults. The risk of appendicitis is 8.6% for men and 6.7% for women throughout a lifetime, with the frequency peaking in the second decade of life. In 19% of acute appendicitis cases, there is perforation, and it has a bimodal distribution. Appendiceal gangrene and perforation appear to be caused by the appendiceal lumen being blocked. Gangrenous appendicitis and free bacterial contamination of the peritoneal cavity result from ischaemic necrosis of the appendix wall. Extreme ages, diabetes mellitus, immunosuppressive diseases, and obstruction of the appendix lumen are risk factors for appendix perforation. Advances in radiographic imaging have increased diagnostic accuracy, although the diagnosis of acute appendicitis remains primarily clinical. Ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans are the imaging modalities presently in use. Early appendectomy continues to be the best option and the least contentious treatment for acute appendicitis. The accepted standard of care for perforated appendicitis includes both open and laparoscopic procedures. Antibiotic prophylaxis responds effectively to complicated appendicitis.