Presentation and Outcome of Acute Appendicitis in the Governmental Referral Hospitals In Sana'a City Yemen, 2023
DOI:
https://doi.org/10.65693/irss.2024.v5i1.360Keywords:
Acute Appendicitis, Presentation, Outcomes, Appendectomy, Open Surgery, Length of Stay (LOS), Sana'a, Yemen.Abstract
Background: Acute appendicitis is one of the most common causes of intra-abdominal emergency surgery worldwide. We aimed to identify the presentation, diagnosis, and management of acute appendicitis and post-operative outcome and also to estimate the prevalence of complicated appendicitis and prolonged length of stay (LOS).
Materials and Methods: A descriptive cross-sectional prospective study was conducted in the department of general surgery in referral hospitals in Sana’a during the period Dec. 2022 to Feb. 2023. Data was collected using questionnaires and face-to-face interviews, and analyzed using Epi Info 7.5 and Excel.
Results: Out of 155 patients, the mean age was 23.4 \pm 10 years, and 61.3% were male. The mean duration of symptoms was 22 hours. The most common presenting symptom was right lower quadrant pain (95.5%) followed by migration of abdominal pain (94.8%). The most common physical sign was rebound tenderness (100%). All patients (100%) underwent pre-operative ultrasound. Open appendectomy was performed in 98.1% of patients; laparoscopic appendectomy was not performed. The mean length of hospital stay was 3 days. Postoperative surgical complications (infection/bowel injury) occurred in 2%, with zero mortality.
Conclusion: The impact of shortening every person’s length of stay by less than three days will have a large impact and free up hospital beds for other more critical cases.
References
بناءً على قائمة المراجع الواردة في الصفحة 14 و15 من البحث المرفق (*Presentation and Outcome of Acute Appendicitis in the Governmental Referral Hospitals In Sana'a City Yemen, 2023*)، تم إعادة تنظيمها وصياغتها وتنسيقها وفق **أسلوب جمعية علم النفس الأمريكية (APA Style - الإصدار السابع)**، مرتبة **أبجدياً** حسب اللقب (الاسم الأخير) للمؤلف الأول:
---
### قائمة المراجع (References)
1. Alyamani, A., et al. (2021). Prevalence and seasonality of acute appendicitis. *Hadhramout University Journal of Natural & Applied Sciences*, 15(1). [https://digitalcommons.aaru.edu.jo/huj_nas/vol15/iss1/5](https://www.google.com/search?q=https://digitalcommons.aaru.edu.jo/huj_nas/vol15/iss1/5)
2. Bhangu, A., Søreide, K., Di Saverio, S., Tang, J. H., Waheed, K. B., & Spurrier, E. (2015). Acute appendicitis: Modern understanding of pathogenesis, diagnosis, and management. *The Lancet*, 386(10000), 1278–1287.
3. Carr, N. J. (2000). Clinicopathological aspects of appendicitis. *Annals of Diagnostic Pathology*, 4(4), 252–258.
4. Cervellin, G., Mora, R., Ticinesi, A., Meschi, T., Comelli, I., Catena, F., & Lippi, G. (2016). Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: Retrospective analysis of 5,340 cases. *Annals of Translational Medicine*, 4(19), Article 362.
5. Collaborative SCOAP, Cuschieri, J., Florence, M., Flum, D. R., Jurkovich, G. J., Lin, P., Steele, S. R., Symons, R. G., & Thirlby, R. C. (2008). Negative appendectomy and imaging accuracy in the Washington State Surgical Care and Outcomes Assessment Program. *Annals of Surgery*, 248(4), 557–563.
6. Di Saverio, S., Podda, M., De Simone, B., Ceresoli, M., Augustin, G., Gori, A., Boermeester, M., Sartelli, M., Coccolini, F., Catena, F., & Kluger, Y. (2020). WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. *World Journal of Emergency Surgery*, 15(1), Article 27. [https://doi.org/10.1186/s13017-020-00306-3](https://doi.org/10.1186/s13017-020-00306-3)
7. Flum, D. R. (2015). Acute appendicitis — Appendectomy or the "antibiotics first" strategy. *The New England Journal of Medicine*, 372(20), 1937–1943.
8. Gomes, C. A., Abu-Zidan, F. M., Sartelli, M., Di Saverio, S., Parreira, J. G., Gomez, C. A., ... & Catena, F. (2018). Management of appendicitis globally based on income of countries (MAGIC) study. *World Journal of Surgery*, 42(12), 3903–3910.
9. Humes, D. J., & Simpson, J. (2006). Acute appendicitis. *BMJ*, 333(7567), 530–534.
10. Ilves, I. (2014). Seasonal variations of acute appendicitis and nonspecific abdominal pain in Finland. *World Journal of Gastroenterology*, 20(14), 4037–4042.
11. Livingston, E. H., Woodward, W. A., Sarosi, G. A., & Fiaccone, W. J. (2007). Disconnect between incidence of nonperforated and perforated appendicitis: Implications for pathophysiology and management. *Annals of Surgery*, 245(6), 886–892.
12. Martínez-Pérez, A., Payá-Llorente, C., Santarrufina-Martínez, S., Sebastián-Tomás, J. C., Martínez-López, E., & de'Angelis, N. (2020). Predictors for prolonged length of stay after laparoscopic appendectomy for complicated acute appendicitis in adults. *Surgical Endoscopy*, 35(10), 5707–5714. [https://doi.org/10.1007/s00464-020-07841-9](https://www.google.com/search?q=https://doi.org/10.1007/s00464-020-07841-9)
13. Obadiel, et al. (2021). Management of complicated appendicitis. *Arab Journal for Sciences & Research Publishing*. [https://doi.org/10.26389/AJSRP.D060521](https://www.google.com/search?q=https://doi.org/10.26389/AJSRP.D060521)
14. Rojas-García, A., Turner, S., Pizzo, E., Hudson, E., Thomas, J., & Raine, R. (2018). Impact and experiences of delayed discharge: A mixed-studies systematic review. *Health Expectations*, 21(1), 41–56. [https://doi.org/10.1111/hex.12619](https://www.google.com/search?q=https://doi.org/10.1111/hex.12619)
15. Sartelli, M., Baiocchi, G. L., Di Saverio, S., Ferrara, F., Labricciosa, F. M., Ansaloni, L., ... & Catena, F. (2018). Prospective observational study on acute appendicitis worldwide (POSAW). *World Journal of Emergency Surgery*, 13, Article 19.
16. Abuarij, M., & Al Qtwani, A. (2023). Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Acne Vulgaris at Al-Thawrah General Hospital, Sana’a, Yemen . Journal of 21 September University for Medical and Applied Sciences, 2(1), 17-30. https://doi.org/10.65693/masj.2023.v2i1.23
17. Van Dijk, S. T., van Dijk, A. H., Dijkgraaf, M. G., & Boermeester, M. A. (2018). Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. *British Journal of Surgery*, 105(8), 932–945. [https://doi.org/10.1002/bjs.10873](https://www.google.com/search?q=https://doi.org/10.1002/bjs.10873)
18. Van Rossem, C. C., Bolmers, M. D. M., Schreinemacher, M. H. F., van Geloven, A. A. W., & Bemelman, W. A. (2016). Prospective nationwide outcome audit of surgery for suspected acute appendicitis. *British Journal of Surgery*, 103(1), 144–151.
19. Viniol, A., Keunecke, C., Biroga, T., Sekanina, U., Catalany, M., Becker, A., & Donner-Banzhoff, N. (2014). Studies of the symptom abdominal pain — A systematic review and meta-analysis. *Family Practice*, 31(5), 517–529.
20. Measar, M., & Al-Hoothi, E. (2023). Giant Cerebral Cavernoma: A Case Study. Journal of 21 September University for Medical and Applied Sciences, 2(1). https://doi.org/10.65693/masj.2023.v2i1.21
21. Alyahawi, A., Al-Wesabi, M., & ALKaf, A. (2022). Antimicrobial susceptibility of Acinetobacter clinical isolates among ICU Patients in Sana’a City, Yemen. Journal of 21 September University for Medical and Applied Sciences, 1(1). https://doi.org/10.65693/masj.2022.v1i1.14
22. Alyahawi A, Measar M, Alwesabi M, Alkaf A. (2024). Clinically Significant Statin-Drug Interactions in Older Patients with Chronic Diseases. Pharmaceutical Research - Recent Advances and Trends Vol. 4, B P International, pp.1-21. https://doi.org/10.9734/bpi/prrat/v4/598
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Aref Al-Hashedi، Ahlam Al-Saidi، Mohammed Al-Sanwi، Radfan Ali et al (المؤلف)
This work is licensed under a Creative Commons Attribution 4.0 International License.
