Epidemiology, Management, and Outcome of Perforated Appendicitis

A BSTRACT Background: Perforated appendicitis, a severe complication of acute appendicitis, is associated with increased morbidity and mortality due to abscess formation, peritonitis, and sepsis. This study investigates its epidemiology, management, and outcomes in a tertiary care setting. Methodology: This observational study, conducted at the Government Medical College, Jammu, from August 2023 to July 2024, included 100 patients with perforated appendicitis. Patients aged >5 years diagnosed with perforated appendicitis were enrolled after ethical approval and informed consent. Data on demographics, clinical presentation, laboratory and radiological findings, surgical interventions, and postoperative outcomes were collected. Statistical analysis used SPSS v19.0, with Chi-square tests for associations ( P < 0.05). Results: The mean age of patients was 28.86 ± 19.97 years, with 40% aged 15–30 years; 77% of patients were male, and 58% of patients resided in rural areas. Common symptoms included nausea/vomiting (72%), fever (64%), and migratory pain (55%). Tenderness in the right iliac fossa was noted in 54% of patients. Open appendectomy was performed in 51% of patients and exploratory laparotomy in 49% of patients. Escherichia coli was the most common organism cultured (48%). Antibiotic susceptibility was observed in 74% of patients, with a significant association between microbial flora and susceptibility ( P < 0.001). Postoperative wound infections occurred in 18% of patients. The mean hospital stay was 6.57 ± 3.97 days. Conclusion: Perforated appendicitis predominantly affects young males and is associated with delayed presentation, increasing perforation risk. Prompt surgical intervention and antimicrobial therapy are effective, though complications like wound infections persist. Early diagnosis and management are critical to improving outcomes.