Acute appendicitis at Kenyatta National hospital; an audit

Abstract

Appendicitis still remains a diagnostic challenge particularly in women and extremes of age. The incidence of appendicectomy for suspected appendicitis is higher but declining in the developed countries in contrast with a low but increasing incidence in Africa. Objective: to describe the characteristics of appendicitis at Kenyatta national hospital, with emphasis on epidemiological oddities. Design: a prospective descriptive study. Setting: Kenyatta national hospital, a 2000 bed teaching and referral hospital in Nairobi, Kenya subjects: one hundred and eighty nine patients managed for suspected acute appendicitis between July 2000 and June 2001. Results: there were 116 males and 73 females. The peak incidence was in the third decade. Sixty four percent of patients were below 30 years of age. The elderly (< 60 years of age) accounted for 1.6% of cases. The rate of false appendicectomy was 18.0%. This rate of negative appendicectomies was 12.9% for males and 30.1% for females. The rate of perforation/gangrene was 29.7%. Hospital stay averaged 6.4 days. Overall morbidity was 12.3%. It was 19.4% in perforated appendicitis and 7.6% in non-perforated appendicitis. There was no mortality. Conclusion: the incidence of appendicitis has increased at Kenyatta national hospital over the last 30 years. The disease is common in men in their third decade. These odd characteristics warrant further investigations.