NEGATIVE APPENDICECTOMY

ITS PREVALENCE , AN EXPERIENCE

Abstract

Objective: To find out the rate of normal appendix in patients operated
for clinically, diagnosed acute appendicitis. Design: Prospective study. Place and duration of study: Department of
Surgery, Combined Military Hospital, Rawalpindi from 17 Feb 2001 to 08 Aug 2001.Patients and methods: One
hundred consecutive patients of acute appendicitis diagnosed clinically were included in the study. All cases of
appendicitis were operated within twenty-four hours of admission. All appendicectomies were sent for histopathological
confirmation of diagnosis at Armed Forces Institute of Pathology Rawalpindi. Results: The mean age for patients was
30.6 year. Pain started in right iliac fossa in forty eight patients (48%), Paraumbilical in thirty eight patients (38%), in
epigastrium in thirteen patients (13%) and right lumbar region in one patient (1%). Right iliac fossa tenderness was
present in all hundred cases (100%) and rebound tenderness was present in seventy patients (70%). Temperature was
normal in thirty-nine patients (39%) and raised in sixty-one patients (61%). Total Leucocyte Count more than
11000/cmm was found in sixty-six patients (66%). Appendicectomy was done in all cases and histopathology revealed
seventy-nine inflammed appendices (79%) and twenty-one (21%) normal appendices. Conclusion: History and clinical
examination is still the most reliable method in the diagnosis of acute appendicitis to reduce incidence of negative
appendicectomy. However ultrasound and diagnostic laparoscopy are especially helpful to exclude acute appendicitis
in women of childbearing age to avoid negative appendicectomy.