A Comparative Study of the Clinical Features between Negative Appendectomy and Conservative Treatment Groups in Suspected Appendicitis

Han, Kwang Hyun; Lim, Jin Sang; Kim, Hae Eun; Choi, Dong Whan; Kim, Sung Chul; Kim, Kwang Tae

Abstract

This study is a clinical review of two groups of patients. Group I was composed of 97 patients who were submitted to negative appendectomy under the impression of acute appendicitis and, group II was 45 patients who received conservative treatment with the same impression at the department of surgery, Dae Rim Saint Mary's Hospital, from January 1, 1994 to August 31, 1996.The purpose of this study is to identify possible factors for the decision of operation or conservative treatment in the patients with suspected appendicitis and so to decrease unnecessary operation. Clinical characteristics of the patients were compared between two groups by the method of comparison of means(X test). The following results were obtained; 1) The incidences of group I and group II among the patients in the state of suspicious appendicitis were 97 of 1,004 cases(9.7%) and 45 of 1,004 cases(4.5%) respectively. 2) The number of female patients was 1.5 times more than male in both groups(p<0.05). 3) In group I the number of patients under 30 years of age was more than that of patients above 30 years of age(p<0.05) and in group II the highest incidence was shown in the patients in forth decades. 4) Symptoms over 3 days were more frequent in group I(31%) and in group II those within 12 hours were prominent(42.2%). 5) Gastrointestinal symptoms of anorexia, nausea and vomiting were more frequent in group I than group II. 6) Body temperature over 37.5 degrees C appeared in 15% of patients in group I and 11% in group II, but this difference showed no statistical significance and there was no sex difference. 7) RLQ rebound tenderness was manifested in 60% of patients in group I and 37.7% in group II, this difference has statistical significance(p<0.05). Migration pain to RLQ appeared in 12% of patients in group I aand 17.7% in group II(p>0.05) 8) Leukocytosis above 10,000/mm3 appeared in 44% of patients in group I and 53.3% in group II(p>0.05). 9) In admission route, the patients via ER was 2 times more than those of OPD in group I and in group II that was 5 times more than this.