title: Acute appendicitis in Lagos: a review of 250 cases.
abstract: OBJECTIVE
  Acute appendicitis is common. This prospective study of 250 cases of acute appendicitis was performed to critically analyse the pattern of presentation, management, operative findings and treatment outcome. The effect of length and position of the appendix in relationship to acute inflammation was also determined.
  
  
  METHODS
  Two hundred and fifty cases of acute appendicitis were studied, including those found to have appendicitis at surgery despite other preoperative diagnosis. Patient biodata, clinical signs and symptoms were recorded. Haematological and biochemical parameters were determined after which all patients with a diagnosis of acute appendicitis had appendicectomy under general anaesthesia. All relevant peri-operative data were recorded. Excised appendices were sent for histological examination.
  
  
  RESULTS
  There were 133 males and 117 females giving a gender ratio of 1.2:1. The mean age was 25.7 +/- 10.3 years, with majority of cases (42.8%) occurring in the third decade of life. Abdominal pain (100%), fever (48.4%), anorexia (48.0%), vomiting (47.8%) were the common symptoms. Commonly elicited signs included right iliac fossa direct tenderness (74.4%), rebound tenderness (59.2%), localised guarding (42.8%) and right rectal wall tenderness (43.2%). The mean white cell count was not significantly elevated (mean 8538 +/- 4166 per mm3, P > 0.05). Sixty three percent (156/245) of all appendices were retrocaecal in position. Mean length of the appendices was 10.4 +/- 2.9 cm. The length and position of appendices were not significantly different between those who had acutely inflamed and normal appendices (P = 0.923) Two hundred and forty five patients (98%) with a diagnosis of acute appendicitis had appendicectomy. The commonest postoperative complication was wound infection (8%), overall complication rate was 13.5% and negative appendicectomy rate was 13.4%.
  
  
  CONCLUSIONS
  The presentation, management and treatment outcome of acute appendicitis in our centre are similar to those of other centres in our sub-region. Complication rates were low.
authors.affiliation: Department of Surgery, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: I B
authors.initials: IB
authors.lastname: Fashina
authors.forename: A A
authors.initials: AA
authors.lastname: Adesanya
authors.forename: O A
authors.initials: OA
authors.lastname: Atoyebi
authors.forename: O O
authors.initials: OO
authors.lastname: Osinowo
authors.forename: C J
authors.initials: CJ
authors.lastname: Atimomo
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001062:Appendectomy / Q000009:adverse effects; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D002648:Child; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011446:Prospective Studies; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult