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KMID : 0371319940460040577
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Journal of the Korean Surgical Society
1994 Volume.46 No. 4 p.577 ~ p.583
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A Clinical Study of Negative Exploratory Laparotomy in Acute Appendicitis
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서준석
김민영/권오중/홍인규/정중기
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Abstract
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Debate continues as to what should be the appropriate "negative" appendectomy rate for patients suspected of having acute appendicitis. Aretrospective investigation was undertaken concerning 490 patients who were submitted to appendectomy on
account of
suspected acute appendicitis during the period of January 1, 1991-August 31, 1993. The diagnostic accuracy was found to be 72.7%. The negative appendectomy rate in female was 36.4% compared to 17.2% in male and that was statistically
significant(p<0.0001).
Among negative appendectomy cases, the number of female was always larger than male in all age groups and this observation was statistically significant in second to fourth decades(p<0.05). The overall leukocytosis rate was 39% in negative
appendectomy
cases and was higher in female(43%) than in male(30%), but this difference was not significant. The number of negative appendectomy cases with clinical features typical of acute appendicitis-rebound tenderness and leukocytosis-was 24(18%). The
number of
pathologic conditions found during laparotomy excluding pelvic imflammatory disease was 8(6%). These results point to a number of aspects of the diagnosis and management of acute appendicitis where there appears to be room for future improvement
especially in female patients.
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KEYWORD
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