Abstract

To determine if the site of perforation of appendix has any effect on post-operative complications. Methodology Patients with diagnosis of appendicular perforation confirmed intra-operatively were allocated into 3 groups based on the site of perforation (Group A – Tip, Group B – Base, Group C – Body of appendix). The patients where a definite site of perforation could not be found were excluded. Baseline data, Intra-operative complications, prevalence of risk factors and post-operative outcomes were noted. Results Total of 57 patients were included in the study. Group A had 31 patients, Group B had 20 patients and Group C had 6 patients. The prevalence of risk factors found in this study were, time delay till appendectomy (68.42 %), male gender (68.42 %), presence of faecolith (57.89 %), age over 50 years (43.86 %), diabetes mellitus (33.33 %) and history of previous surgery (36.84 %). 4 out of 20 patients in Group B had iatrogenic bowel injury compared with 2 out of 31 patients of Group A. 3 patients of Group B had a gangrenous base without a residual healthy stump. The patients with perforation at the base had higher length of hospital stay (p- value 0.031) and mean CCI score (p- value 0.036) compared with other groups. Conclusion Patients with perforation of appendix base had higher incidence of intraoperative and post-operative complications. Knowing the site of perforation may help the surgeon to plan a proper intraoperative and postoperative management protocol.

Description