Does delay in diagnosing acute appendicitis affect the outcome?

الملخص EN

Acute appendicitis is the most common surgical case met in an emergency department.

Immediate surgery results in the confirmation of diagnosis and control of sepsis.

To determine whether the delay in operating upon patients with acute appendicitis will affect the outcome or the stage of the disease, and if the clinical param¬eters give an indication of the severity of the disease medical records were reviewed retrospectively of 373 appendectomized patients above 14 years of age who were diagnosed with appendicitis in the emergency department of Hamad General Hospital, State of Qatar, between June and September 2007 ; 341 were diag¬nosed as acute appendicitis.

Patients were classified according to the pre-operative and histopathological findings into four grades; A1 : inflamed appendix, A2 : gangrenous appendix, A3 : perforated appendix, A4 : pus + /- mass formation.

Complications increased with the duration of the pre-hospital delay.

The length of stay in hospital correlated significantly with the grade of diag¬nosis.

The presence of fever, no change in bowel habit, and rigidity correlated well with advanced pathology, the complications increasing with greater delay.

We conclude that delayed appendectomy is unsafe since it is associated with an increase in pathological grading as well as increasing the morbidity and the length of stay in hospital.