Abstract
Objectives. Rates of negative laparotomy (NL) for acute appendicitis have been reported as 15% and parasitosis contributed to 2%. This study was planned to reduce the rates of NL by preoperative determination of parasitosis. Methods. In retrospective examination of 2730 appendectomy specimens in Hitit University Department of General Surgery between 2008 and 2012, 55 patients were determined with parasitosis and compared with 102 age-matched randomly selected patients with lymphoid hyperplasia. Results. The parasite group comprised 63.6% females with a mean age of 15.1 years. The number of patients in the parasitosis group increased from city centre to rural areas of towns and villages (p<0.001). While a lower rate of sonographic findings was found in the parasitosis group, the findings of inflammation in the histopathological evaluation were significantly low (p=0.014, p=0.0011, resp.). A significant difference was determined between groups in respect of the eosinophil and haematocrit values. In the differentiation of patients with parasites, eosinophil of >2.2% was determined as a diagnostic value. Conclusion. It is important to determine parasitosis to prevent NL. When acute appendicitis is considered for young patients living in rural areas, the observation of high eosinophil together with negative sonographic findings should bring Enterobius vermicularis parasitosis to mind and thereby should prevent NL.
Highlights
Acute appendicitis is the pathology requiring the most frequent emergency surgery in General Surgery and appendectomy is the most common surgical procedure worldwide [1]
The reason for these higher than expected rates of appendectomy is that appendectomies are performed during negative laparotomies on patients admitted for surgery because of a clinical table resembling acute appendicitis
We aim to investigate the predictability of parasite etiopathogenesis with tests applied in the preoperative period to patients with an initial diagnosis of acute appendicitis (AA) and by planning medical treatment, thereby preventing negative laparotomy
Summary
Acute appendicitis is the pathology requiring the most frequent emergency surgery in General Surgery and appendectomy is the most common surgical procedure worldwide [1]. The rates of appendectomy performed during laparotomy for an initial diagnosis of acute appendicitis (AA) are 12% for males and 25% for females [2]. The reason for these higher than expected rates of appendectomy is that appendectomies are performed during negative laparotomies on patients admitted for surgery because of a clinical table resembling acute appendicitis. More than the experience of unnecessary surgical trauma for patients, negative laparotomies may cause more serious problems in the future such as ileus associated intra-abdominal adhesions and female infertility due to tubal contractions
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