Clinical, Diagnostic and Therapeutic Aspects of Acute Appendicitis at the Reference Health Center of Commune I-Bamako

Abstract

Acute appendicitis is the most frequent abdominal surgical emergency in the world. The aim of this study was to analyse the results of surgical management of acute appendicitis. Methodology: This was a prospective study from January 2020 to December 2020 in the reference health centre in Commune I of Bamako. Results: During this period, we operated on 108 patients for acute appendicitis, including 78 men and 30 women, for a sex ratio of 2.5. The mean age was 26.92 years, ranging from 5 to 70 years. Abdominal pain was the main reason for consultation. Physical signs were dominated by a positive Blumberg's sign in 99.1% of cases, right iliac fossa defensiveness in 97.2% of cases, Rovsing's sign in 50% of cases, psoitus (Psoitis) in 18.5% and pain on the right in the cul de sac of Douglas in 69.4%. This physical examination enabled the diagnosis to be made in the majority of cases. In some doubtful cases, we requested an abdominal ultrasound scan. Locoregional anaesthesia was the most commonly used anaesthetic technique (63.9%). Classic Mac Burney appendectomy with burial of the stump was the surgical technique most frequently used. Postoperative recovery was straightforward in 97.2% of cases. However, we recorded one case of death. Conclusion: Acute appendicitis remains the most frequent abdominal surgical emergency in the community. Early diagnosis and rapid management improve prognosis. Treatment is essentially surgical.