Incidence of Negative Appendicectomy: Correlation Between Clinical, Peroperative and Histopathological Findings

Abstract

Appendicitis is one of the most difficult diagnostic problems to confront the emergency physician and it is the most common intra-abdominal condition requiring emergency surgery. The term Negative appendicectomy used for operation done for suspected appendicitis, in which the appendix is found to be normal on histological evaluation. The study aimed to find out the incidence of negative appendicectomy evaluating the correlation between clinical, per-operative and histopathological findings. It was a prospective study of 100 cases clinically diagnosed as acute appendicitis selected over a period of one year (July 2006 to June 2007) from different surgical ward of Mymensingh Medical College Hospital. The study revealed a negative appendicectomy rate of 12%. Moreover, in all cases of acute appendicitis, there was a well established bias towards male patients and young male patients constituted the majority of the cases. But the rate of negative appendicectomy found to be higher in female patients, which is 15.9% as compared to only 8.92% male patients. In addition, among female patients differential diagnostic difficulties encountered in females of reproductive age group. More emphasis on technology at the expense of clinical evaluation is certainly responsible for the diminish in accuracy of diagnosis. The diagnosis of acute appendicitis remains essentially clinical, requiring a mixture of observation, clinical acumen and accurate use of diagnostic tools.  A correct diagnosis is certainly important than a rapid diagnosis.