title: Appendicitis and its surgical management experience at the University of Maiduguri Teaching Hospital Nigeria.
abstract: BACKGROUND
  Acute appendicitis and its complications is still the most common cause of acute abdominal pain that will require surgical intervention in most parts of the West African sub-region. This study is a review of our management and outcome of acute appendicitis in the University of Maiduguri Teaching Hospital [UMTH].
  
  
  METHODS
  A retrospective and prospective audit of all patients with acute appendicitis seen and managed over an 8- year period [2002-2009 inclusive] in the UMTH is presented. Materials used included patients demographic variables, clinical presentation, laboratory data, operative findings and treatment outcome.
  
  
  RESULTS
  One thousand two hundred and fifty-seven patients were studied. These were 426 (33.9%) males and 831 (66.1%) females; a male to female ratio of 1:2. The mean age was 32.4 15.0 years. All the patients were admitted with abdominal pain that was initially located at the right iliac fossa in 480 (38.2%), periumbilical in 393 (31.3%) and diffused in 351(27.9%) patients. Vomiting 85.7%, fever 73.0% and anorexia 49.0% were the most frequent symptoms. The mean duration of illness was 72 hours. Right iliac fossa pain and tenderness were present in 1112 (88.46%) patients. The total white cell count was significantly raised (p < 0.05). All the patients had appendicectomy, 295 (23.47%) of the appendices were perforated at operation and 200 (15.9%) of the removed appendices had no histological evidence of inflammation. The complication rate was 36.2% and wound infection (28.30%) was the most common. The mean hospital stay was 3 days. There were 12 deaths; a mortality rate of 0.9%; mostly patients with ruptured appendix and peritonitis.
  
  
  CONCLUSIONS
  The diagnosis of appendicitis is clinical and supported by a raised total white cell count with neutrophilia. The negative appendicectomy rate of 15.9% falls below the range reported in other studies. More than a fifth of the appendices were perforated and mortality was low.
authors: Department of Surgery, College of Medical Sciences, University of Maiduguri, Nigeria. nuhualinvwa@yahoo.com
authors: N
authors: N
authors: Ali
authors: S
authors: S
authors: Aliyu
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000855:Anorexia / Q000209:etiology; D001062:Appendectomy / Q000009:adverse effects; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009549:Nigeria; D013530:Surgical Wound Infection / Q000209:etiology; D014839:Vomiting / Q000209:etiology; D055815:Young Adult