Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Affiliation
Department of Surgery, Mid-Western Regional Hospital, University of Limerick,, Limerick, Ireland.Issue Date
2012-01-31T16:47:29ZMeSH
Abdominal Pain/*diagnosis/*surgeryAcute Disease
Adolescent
Adult
Appendectomy
Appendicitis/*diagnosis/*surgery
Child
Diagnosis, Differential
Female
Genital Diseases, Female/*diagnosis/*surgery
Humans
*Ilium
Intestinal Diseases/*diagnosis/*surgery
Laparoscopy
Logistic Models
Male
Prospective Studies
Statistics, Nonparametric
Treatment Outcome
Metadata
Show full item recordCitation
Surgeon. 2010 Aug;8(4):211-7. Epub 2010 Feb 8.Journal
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandDOI
10.1016/j.surge.2009.11.008PubMed ID
20569941Abstract
BACKGROUND: Right iliac fossa (RIF) pain remains the commonest clinical dilemma encountered by general surgeons. We prospectively audited the management of acute RIF pain, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. METHODS: Over a six-month period, 302 patients, median age 18 years, 59% female, were admitted with RIF pain. Symptoms, clinical findings and laboratory results were documented. Patient management, timing of radiological investigations and operations, and outcome were recorded prospectively. RESULTS: Non-specific abdominal pain (26%), gynaecological (22%) and miscellaneous causes (14%) accounted for most admissions. Ultimately, 119 patients (39%) had appendicitis. Anorexia, tachycardia or rebound tenderness in the RIF significantly predicted a final diagnosis of appendicitis. Patients with perforated appendicitis (n = 29) had a longer duration of pre-hospital symptoms (median 50h) compared to those with simple appendicitis (median 17 h) (p<0.001). The use of pre-operative imaging resulted in an increased time to surgery but was not associated with increased post-operative morbidity or perforated appendicitis. CONCLUSION: The majority of patients presenting to hospital with RIF pain did not have appendicitis. Increased duration of pre-hospital symptoms was the main factor associated with perforated appendicitis. However, increased in-hospital time to theatre was not associated with perforated appendicitis or post-operative morbidity.Language
engISSN
1479-666X (Print)1479-666X (Linking)
ae974a485f413a2113503eed53cd6c53
10.1016/j.surge.2009.11.008
Scopus Count
Collections
Related articles
- Should an appendix that looks 'normal' be removed at diagnostic laparoscopy for acute right iliac fossa pain?
- Authors: Teh SH, O'Ceallaigh S, Mckeon JG, O'Donohoe MK, Tanner WA, Keane FB
- Issue date: 2000 May
- Can serum interleukin-6 levels predict the outcome of patients with right iliac fossa pain?
- Authors: Goodwin AT, Swift RI, Bartlett MJ, Fernando BS, Chadwick SJ
- Issue date: 1997 Mar
- [Pain syndrome in the right iliac fossa and laparoscopy: routine appendectomy or not?].
- Authors: Luthi F, Dusmet M, Merlini M
- Issue date: 1993 Sep
- Clinical presentation and treatment considerations in children with acute omental torsion: a retrospective review.
- Authors: Vázquez BJ, Thomas R, Pfluke J, Doski J, Cofer B, Robertson F, Kidd J
- Issue date: 2010 Apr
- [Right iliac fossa pain in women. Conventional diagnostic approach versus primary laparoscopy. A controlled study (65 cases)].
- Authors: Champault G, Rizk N, Lauroy J, Olivares P, Belhassen A, Boutelier P
- Issue date: 1993