Abstract
Introduction: Acute appendicitis is the major surgical abdominal disease in emergency departments and is also among the five leading causes of litigation against emergency physicians. Delayed diagnosis of appendicitis is more likely to occur in patients, who present atypically, and those lack a thorough physical examination, or those received intramuscular narcotic analgesia. The aim of this study was to study the effect of delay in diagnosis of acute appendicitis as regard postoperative findings, length of hospital stay and post-operative complications. Patients & Methods: Patients with complicated appendicitis were subjected to the present study and treated by a single surgical team. The parameters of our study were incidence of perforation or gangrene at surgery, length of stay and post-operative complications. Results: The present study showed that delay in diagnosis of acute appendicitis is associated with a more advanced stage of disease and a higher morbidity. Conclusion: careful attention to the patient’s history; a thorough physical examination and early clinical review help to minimize the possibility of delayed diagnosis of appendicitis. Appendicitis with a delay in treatment usually leads to high perforation rates, and unfavorable outcome.
Highlights
Acute appendicitis is the major surgical abdominal disease in emergency departments [1] and it is among the five leading causes of litigation against emergency physicians
Results: the present study showed that delay in diagnosis of acute appendicitis is associated with a more advanced stage of disease and a higher morbidity
Appendicitis with a delay in treatment usually leads to high perforation rates, and unfavorable outcome
Summary
Acute appendicitis is the major surgical abdominal disease in emergency departments [1] and it is among the five leading causes of litigation against emergency physicians. The vast majority of causes of the claims against physicians were clustered around “diagnosis error”, accounting for about one-third of the claims [2]. It is still difficult to make a correct preoperative diagnosis early enough that patients can avoid unnecessary appendectomies and reduce the risk of perforation. This is because the initial symptoms of early appendicitis are nonspecific and may often confuse treating physicians. Attempts at seeking a correct diagnosis and avoiding unnecessary appendectomies may cause the delay of surgery and increase the possibility of perforation and morbidity [4]
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