Clinical and imaging characteristics relating to surgical outcomes of perforated appendicitis.
OBJECTIVE
To study the characteristics of clinical findings and CT imaging of perforated appendicitis for predicting the outcome of patients who received immediate appendectomy for perforated appendicitis.


METHODS
Thirty-eight patients with perforated appendicitis who received immediate appendectomy were retrospectively reviewed. During a median follow-up period of 1091 days, 13 patients had to be re-hospitalized owing to occurrence of complications relating to the immediate appendectomy. Accordingly, the patients were divided into two groups as either complication or non-complication group. The clinical characteristics and CT imaging of these two groups were compared.


RESULTS
Those patients who delayed seeking medical advice were more prone to develop surgical complications after immediate appendectomy. CT imaging showing either fat stranding with remarkable fluid content or abscess indicates the presence of severe inflammation and is related to adverse surgical outcomes. Moreover, extraluminal appendicolith was more frequently found in the CT imaging of complication group.


CONCLUSIONS
Patients with perforated appendicitis differ in their severity. Patients who seek medical advice late or have signs of severe inflammation or extraluminal appendicolith on their CT imaging are associated with more severe diseases and are prone to develop complications of surgery at this time and should be better treated conservatively.
Department of Radiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Hong-Ming
HM
Tsai
Yan-Shen
YS
Shan
Pin-Wen
PW
Lin
Xi-Zhang
XZ
Lin
Chiung-Yu
CY
Chen
D018784:Abdominal Abscess / Q000209:etiology; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000009:adverse effects; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D045823:Ileus / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000453:epidemiology; D000267:Tissue Adhesions / Q000150:complications; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome