Abstract
Background: Perforated appendicitis is the result of a delay in treating acute appendicitis either due to patient's related factors, or misdiagnosis and delay of treatment.
Aim: The aim of this study to evaluate the effect of time on perforated appendicitis cases to determine whether the delay in presentation or the delay in treatment have a role in the progressing of acute appendicitis to perforation of the appendix.
Materials and Methods: A retrospective database analysis of 2573 Saudi Arabian patients treated surgically for acute appendicitis between January 2006 and December 2015 in a public health general hospital in Medina, Saudi Arabia was done. The inclusion criteria included adult patients, diagnosed initially as acute appendicitis, and proven to have had perforated appendix. Diagnostic temperature, complete blood count, ultrasound, operative diagnosis, duration of symptoms, duration of hospitalization, and complications were analyzed.
Results: A total of 363 patients (145 females and 218 males) were proven to have had a perforated appendix. The number was higher in males compared to females, and the difference was statistically significant (P = 0.033). The mean age of the patients was 29.99 (median 26, range: 14-79). The duration of symptoms was significantly longer (68.80 +/- 12.40 h and P < 0.001), and it was statistically significant for both males (P = 0.004) and females (P = 0.001).
Conclusion: To conclude that in our local community, the majority of perforated appendix cases were found to be associated with the delay in presentation rather than the delay in management.