For years, it has been acceptable to have a certain percentage of negative findings at appendectomy, otherwise, perforation would occur, resulting in morbidity and mortality.
Acute appendicitis can be a difficult disease to diagnose, and occasionally surgery for appendicitis is performed only to find a normal appendix during the operation. These negative explorations results in minimal morbidity & mortality, but
documentation on this in the literature is sparse.
This study was carried out to define the factors affecting perioperative morbidity and mortality in patients with negative findings at appendectomy. A retrospective investigation was undertaken involving 132 patients who were submitted to
appendectomy
on account of suspected appendicitis, but who were found to have normal appendix during the period of August 1. 1993-August 31, 1995 at the department of surgery, Pohang St. Mary's Hospital.
@ES The results were as follows:
@EN 1) The negative appendectomy rate was 19%.
2) The incidence of negative appendectomy in female was higher(25%) than in male(14%) (p<0.01).
3) Among negative appendectomy cases, the groups under 50 years of age was always higher than the groups above 50 years of age(p<0.01).
4) Duration of symptoms over 3 days was prominant(48.5%) in negative appendectomy.
5) RLQ pain with other site pain was predominant(63.6%) in negative appendectomy cases.
6) In negative appendectomy groups, the GI symptoms of anorexia, nausea, vomiting and diarrhea were frequent(34.1%, 47.1%, 22.7%, 32.6% respectively).
7) The rebound tenderness in negative appendectomy was 41.8%, but there is no sex difference.
8) The typical muscle guarding in negative appendectomy was 33.3%.
9) The leukocytosis above 10,000 m3 in negative appendectomy was 20.5% in male compared to 23.5% in female, but this difference was not significant.
10) The most common pathologic condition which proved other disease with normal appendix was non-specific mesenteric lymphadenopathy(21.7%).
11) The most common complication was wound infection(9.8%).
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