Publication:

Clinical presentation, intraoperative findings and short-term outcomes among patients with appendicitis at Mbarara Regional Referral Hospital

Background Appendicitis remains a significant cause of acute abdomen and is characterized by high complication rates despite advancements in surgical care. Factors influencing post appendectomy outcomes, including clinical presentation, intraoperative findings, and procedural interventions, require detailed documentation in our context.

Methods This retrospective study analyzed 108 patients who were managed surgically for appendicitis. Demographic data, clinical parameters, intraoperative findings, hospital stays, and postoperative complications were assessed. Multivariate logistic regression identified factors associated with unfavorable outcomes (p 100 bpm. The subumbilical midline incision (SUMI) was predominant (54.6%), while 20.4% presented with a ruptured appendicular abscess. Postoperatively, 23.6% of the patients experienced complications, predominantly constipation (43.5%) and surgical site infections (20.3%). Factors significantly increasing the odds of unfavorable outcomes included age 40-59.9 years (aOR=9.66; 95% CI 1.82-15.2), symptom duration >5 days (aOR=6.14; 95% CI 1.69-12.2), ruptured appendicular abscess (aOR=23.96; 95% CI 1.75-11.97), and peritoneal lavage (aOR=7.72; 95% CI 1.69-9.1).

Conclusions In this study, most of the patients presented nonspecifically and late with complicated forms of appendicitis, indicating a high incidence of unfavorable postoperative outcomes. We therefore need to increase awareness of the nonspecific presentation and unfavorable outcomes related to late presentation of the condition to all health workers and communities. The adoption of screening protocols such as the Alvarado score could help ensure timely diagnosis and prediction of treatment outcomes to reduce the burden of unfavorable outcomes.