A COMPARISON OF OUTCOMES BETWEEN UNCOMPLICATED AND COMPLICATED APPENDICITIS. CAN A RATIONAL APPROACH OF INJECTABLE ANTIBIOTICS BE APPLIED FOR UNCOMPLICATED APPENDICITIS? - A SINGLE CENTRE EXPERIENCE.

Background: Acute appendicitis is the most common surgical emergency in young adults. A delayed presentation of a patient with uncomplicated appendicitis may progress to a complicated appendicitis (appendicular phlegmon, gangrene, perforation abscess, localized or generalized peritonitis). Emergency Surgery is the standard of care. Material and Methods: We have prospectively analysed 167 patients with proper informed consent to participate in the study, having satisfied our inclusion criteria. 86 patients had uncomplicated appendicitis and 81 had complicated appendicitis. The presentation and surgical outcomes of both these clinical entities were compared and the feasibility of a rational dose of single day course of antibiotics has been evaluated statistically. Results and Analysis: Of 167 patients the majority of patients were within the age group of 11-20, 65(38.9%), with a slight female predominance. Of the 81 patients with complicated appendicitis 45.7% presented with a Phlegmon .Mean days of symptoms of patients in complicated appendicitis, was 3.1852 ?.8531 days compared to 1.5698 ?.4980 days uncomplicated Most of the complicated cases had fever during presentation. Mean operative time (40.6914 ?10.3388 mins) , incidence of wound infection (22%) , ileus (29.6%) is more in complicated appendicitis. There was one case of Faecal fistula. The mean duration of antibiotics is more in complicated appendicitis 9.1975 ?3.4728 days versus 3.5116 ?2.9773 days leading to prolonged stay (5.7160 ?2.7894 days) in complicated cases. Complicated appendicitis patients have more morbidity (ClavienDindo score >1).50 patients out of 85 patients (58%) with uncomplicated appendicitis were given a rationally justified, single day dose of antibiotics, without any complications. Hence the prognoses of such patients were better leading to minimal morbidity