Current Status of and Related Factors Associated with Complicated Appendicitis

Abstract

In recent years, cases of necrotizing and perforated appendicitis have drawn attention and have been referred to as complicated appendicitis (CA). This paper outlines the current status of and the factors involved with CA. Of the 196 patients treated in our department, 89 cases, 45％ belonged to the CA group and 107, 55％ non-CA group. In comparison with the non-CA group, the CA group had more males, older patients and BMI, higher white blood cell count and c-reactive protein (CRP) levels, more frequent emergency surgery and ileocecal resection, longer surgery time, more bleeding, longer incision, more drain placements, more postoperative complications, and longer hospital stay. The significant risk factors for the CA group were CRP levels which were 1.83 mg/dL or more, the white blood cell count which was 14,200/μL or more, and age which was 35 or more. In the guidelines, laparoscopic surgery may be performed for perforated acute appendicitis, non-surgery may be chosen for appendiceal inflammatory mass with no symptoms of peritonitis, postoperative antibiotics are recommended for CA, and percutaneous drainage is also chosen in CA. If emergency surgery is not performed for CA patients, it is important to carefully follow up the patient, taking into consideration the possibility of exacerbation.