Easwar, N (2014) A clinical study of post operative complications of emergency and elective (open & laparoscopic) appendicectomy. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
BACKGROUND: Postoperative complications which follows appendicectomy are not common & it reflect the level of peritonitis that is present during the time of surgery and the diseases which may be predisposed to complications. There are various types of complications that occurred after the appendicectomy surgery. Of them, the commonest complications are fever and surgical site infection. Post-operative complications of appendicectomy have wide range of presentation from fever to fecal fistula. In this study the patients presenting with features of post-operative complications of appendicectomy will undergo detailed history taking, clinical examination & investigations like complete blood count, blood sugar, urea & lipid profile, serum creatinine, Xray chest and wound pus culture sensitivity. The study purpose was to assess the age distribution, sex distribution & to discuss various types of complication. METHODS: 100 cases that have presented with features of post-operative complications of appendicectomy in the department of surgery, Tirunelveli Medical College & Hospital were evaluated during the study period from April 2012 to October 2013. RESULTS: Our study consisted of randomised selected 100 patients who presented with postoperative complications of appendicectomy. The commonest postoperative complications of appendicectomy is fever, it constitutes of about 73% cases. The second most common postoperative complications of appendicectomy is surgical site infection, it constitutes of about 37% cases. Most common age group, in which post-operative complications seen, is > 20 years. The second most commonly affected age group is 20-30 years. The surgical site infections are most commonly due to E.coli, it constitutes of about 64.86% cases having SSI. The next causative organism is Klebsiella sp, which constitutes about 8.1% cases. The remaining cases show no growth in culture. The common day of presentation of fever is 2nd POD with 57.3% cases. In this study 97% case of postoperative complications of appendicectomy occurs after emergency surgeries. CONCLUSION: The following conclusions were obtained from the above prospective clinical study conducted at Tirunelveli Medical College & Hospital during the period of October 2012 to September 2013. • Of the 100 cases, the commonest complication seen in post-operative appendicectomy is fever. • There are 73% of cases presented with fever. • About 61% of patient presented with fever, have risen in temperature on 2nd and 3rd POD. • It implies that the fever is due to inflammation caused by the appendicitis itself. • Among the cases with fever, about 37% of cases also have surgical site infections. • The cases having the rise in temperature due to surgical site infections are on 4th and 5th PODs. • Other cases of fever are ruled out. • There are 37% of cases presented with SSI. • In cases presented with SSI, there was about 27% of cases shows no growth of any organisms in the culture. • Those patient who have no growth of organism in culture, were presented with rise in temperature on 2nd of 3rd POD, it signifies the fever is due to the inflammation caused by the appendicitis but not by the SSI. • In cases presented with SSI, there was about 64.86% of cases have E.coli grown on culture. • E.coli is the most common organism causing SSI in the cases undergoing bowel surgeries is due to contamination of subcutaneous tissue with the bowel contents. • In cases presented with SSI, there was about 8.01% of cases have Klebsiella sp. grown on culture. • There are 3% of cases reported to have paralytic ileus. • All the 3 cases are pre operatively, diagnosed as perforated appendicitis. • They have peritonitis due to inflammation of the appendix spread throughout the peritoneal cavity. • The probable cause of paralytic ileus is the spread of intraperitoneal infection among the coils of intestine. • There are 2% of cases presented with intra-abdominal abscess. • One of the intra-abdominal abscesses which were in the pelvic cavity was drained rectally. • Other was treated conservatively. •1% of cases were presented with fecal fistula. •It was treated conservatively.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Post-operative complications ; Emergency and Elective appendicectomy ; Fever ; Surgical site infections. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 07 Jul 2018 01:14 |
| Last Modified: | 07 Jul 2018 01:14 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8683 |
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