Acute Appendicitis, Diagnostic and Therapeutic Aspects at the Ouelessebougou Reference Health Center Mali

Object: To describe the diagnostic and therapeutic aspects of acute appendicitis at the Reference Health Center of Ouelessebougou. Methodology: This was a retrospective and analytical study, carried out in the surgery department of the reference health center of Ouelessebougou from January 01, 2019 to December 31, 2019. All patients operated on for acute appendicitis were included in this study. Results: Eighty-three (83) patients were listed, representing 18% of surgical procedures. These were 65 men (78.3%) and 18 women (21.7%), the sex ratio was 3.61. The mean age was 25.61 years with extremes of 3 years and 68 years, Standard Deviation =16.11. Most of the patients, 91.56%, were recruited in an emergency. Clinical signs were dominated by iliac fossa pain in 84.4% of cases, defense in the right iliac fossa in 94% of cases, and right pain in the cul de sac of Douglas fir in 86.8% of patients. The mean duration of the disease was 2.5 days with extremes of 1 to 7 days. Neutrophilic polynuclear leukocytosis was noted in 57.8% of cases. C-reactive protein was elevated in 62.7% of patients. Abdominal ultrasound performed in 78 patients (94%) revealed acute uncomplicated appendicitis in 70 patients (89.7%). Traditional medications were used in 21 patients (25.3%). Appendectomy with burial of the stump was performed in 82 patients (98.8%), and the appendix was laterocecal in 74 patients (89.2%). The postoperative follow-up was simple in 96.4% of cases. Morbidity was 3.6% (3 cases). The mean length of hospital stay was 5.36 days with extremes of 3 days and 8 days. The average cost of care was 62,500 CFA francs with extremes of 25,000 and 80,550 CFA francs. Conclusion: Appendicitis is a common surgical emergency in our department. Delay in consultation and traditional medication are the factors of severity.