Acute Appendicitis: Epidemio-Clinical and Therapeutic Aspects in Koutiala, Mali

Abstract

Purpose: To assess the epidemiological, clinical and therapeutic aspects of acute appendicitis at the Koutiala Reference Health Centre. Methods: This was a prospective study conducted in the general surgery department of the Koutiala Reference Health Centre. Patient records admitted for simple and complicated appendicitis during the period from August 1, 2017 to August 31, 2018 have been collected. Patients operated on for simple and complicated acute appendicitis were included in the study. Patients who did not have surgery were excluded. Results: We collected records of 62 patients who had surgery for simple and complicated acute appendicitis. They accounted for 11.9% of surgical procedures (n-520) and 27.3% (n-227) of surgical emergencies. The average age was 33.1 years-15.7. Men were in the majority with 72.5%. Simple acute appendicitis accounted for 56.4% of cases (n-35) and complicated appendicitis 43.6% of cases (these were 16 cases of appendicular peritonitis, 09 cases of appendicular abscess and 02 cases of appendicular plastron). Therapeutically, appendectomy was performed in 58 patients. In 4 patients the appendix was completely necrotized. The average length of hospitalization was 3.3 days-0.8 for single acute appendicites and 6 days-2.7 for complicated appendicites. Postoperative morbidity of complicated appendicitis was 6.4% (no. 4) and mortality was zero. Conclusion: Simple acute appendicitis is more common. Laparotomy remains the only way at present. Postoperative morbidity is high in complicated appendicitis and mortality is zero.