A prospective audit of 300 consecutive young women with an acute presentation of right iliac fossa pain

A prospective audit of 300 consecutive young women with an acute presentation of right iliac fossa pain

A prospective study of 300 women of child-bearing age presenting with right iliac fossa pain was carried out to determine what proportion had appendicitis and whether active observation resulted in a delay in diagnosis to the detriment of the patient. Data were prospectively collected for 300 consec...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England Vol. 88; no. 2; pp. 140 - 143
Main Authors: Rennie, Adam T M, Tytherleigh, Matthew G, Theodoroupolou, Katerina, Farouk, Ridzuan
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01-03-2006
The Royal College of Surgeons of England
Subjects:
Abdomen
Abdominal Pain - etiology
Acute Disease
Adolescent
Adult
Age
Algorithms
Appendectomy
Appendicitis
Appendicitis - complications
Appendicitis - diagnosis
Appendicitis - surgery
Constipation
Crohns disease
Cysts
Early Diagnosis
Emergency
Female
Hospitals
Humans
Infections
Infertility
Laparoscopy
Medical Audit
Middle Aged
Pain
Patients
Pregnancy
Prospective Studies
Surgeons
Surgery
Ultrasonic imaging
Urine
Womens health
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Summary:A prospective study of 300 women of child-bearing age presenting with right iliac fossa pain was carried out to determine what proportion had appendicitis and whether active observation resulted in a delay in diagnosis to the detriment of the patient. Data were prospectively collected for 300 consecutive women of childbearing age referred with right iliac fossa pain to general surgeons at a district general hospital. After clinical assessment, 71 were discharged home immediately. Two others were found to be pregnant and 4 admitted to gynaecology. The remaining 223 women were admitted to the general surgical unit, 112 of whom underwent immediate appendicectomy. Of these, 97 had acute appendicitis. Two suffered deep infection and two had a superficial wound infection. A further decision to operate was made in 42 of 111 patients admitted for active observation, with 36 having acute appendicitis and 2 having a carcinoid tumour. Four had a wound infection. The average in-patient stay of those admitted for active observation and not operated on was 2 days (range, 1-4 days) compared with a length of stay of 2 days (range, 1-7 days) for those who underwent 'immediate' appendicectomy. Most women of child-bearing age who present with right iliac fossa pain do not have appendicitis. Those who do not have the classical features of appendicitis or peritonism can be safely managed by active observation.
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ISSN:0035-8843
1478-7083
DOI:10.1308/003588406X94887