Published: 2021-10-27

Acute appendicitis: is it a seasonal disease?

Yasir Babiker Elshambaty, Saleh A. Alzahrani, Talal A. AlOmari, Waleed S. Shahwan, Abdullah A. Alzahrani, Osama A. Alghamdi


Background: The aim of this study was to review the management of acute appendicitis in a rural hospital. It was generally reported to be more common in men. Appendicitis is the most common surgical cause of abdominal pain worldwide. Appendectomy is the lonely curative treatment of appendicitis.

Methods: This was a retrospective study in which we reviewed the records of the patients who had been diagnosed and operated on for appendicectomy from January to December 2017 in a rural hospital. The data were analyzed with SPSS version 25.

Results: The total number of the patients was 114. About 69.3% are males. The mean age was 25.11 years. About (39.5%) were above 20 years old. Most of the cases presented in the period between January and March (27.3%). Right lower quadrant pain was the most common presenting symptom (93.9%). Nausea and vomiting mentioned by 57 (50%) and 74 (64.9%) of the participants respectively, fever in 42 (36.8%), muscle guarding in 0.9%, tenderness in 44 (38.6%), abdominal ultrasound was requested in 96 (84%). The most common histological diagnosis was acute suppurative appendicitis with peri-appendicitis in 15 (13.2%). All the cases were treated with open appendicectomy.

Conclusions: We concluded that male are more affected with acute appendicitis. The most common presenting symptom was right lower quadrant pain. The vast majority of the cases were in the winter. Ultrasound has been used in the most cases particularly in male more than in females. The most common histological diagnosis was acute suppurative appendicitis. Open appendicectomy is the main operative management in our pts.


Acute appendicitis, Appendectomy, Rural hospital, Histology

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Brunicardi FC, Andersen DK, Billiar TR. The Appendix: acute appendicitis. Schwartz’s Principles of Surgery. 10th ed. New York: McGraw-Hill Education; 2014: 1243-6 .

Medscape. Fact sheet: Appendicitis, 2018. Available at: Accessed on 13 August 2021.

Freud E, Pilpel D, Mares AJ. Acute appendicitis in childhood in the Negev region: some epidemiological observations over an 11-year period (1973-1983). J Pediatr Gastroenterol Nutr. 1988;7(5):680-4

Luckmann R, Davis P. The epidemiology of acute appendicitis in California: racial, gender, and seasonal variation. Epidemiology. 1991;2(50:323-30.

Noudeh YJ, Sadigh N, Ahmadnia AY. Epidemiologic features, seasonal variations and false positive rate of acute appendicitis in Shahr-e-Rey, Tehran. Int J Surg. 2007;5(2):95-8.

Ayoade BA, Olawoye OA, Salami BA, Banjo AA. Acute appendicitis in olabisi onabanjo university teaching hospital Sagamu, a 3-yer review. Niger J Clin Pract. 2006;9(1):52-64 .

Ajao OG. Appendicitis in a tropical African population. J Natl Med Assoc. 1979;71(10):997-9.

Mungadi IA, Jabo JA, Agwu NP. A review of appendicitis in Sokoto, Northwestern Nigeria. Niger J Med. 2004;13:240-3.

Kumar V, Abbas AK, Aster JC, Cotran R. The gastrointestinal tract, small intestine and colon. Acute Appendicitis Pathologic Basis of Disease. 9th ed. Philadelphia: Elsevier; 2014: 816 .

Williams NS, Bulstrode CJK, O'Connell PR. The vermiform appendix. Acute Appendicitis. Bailey and Love’s short practice of surgery. 26th ed. New York: CRC Press; 2013: 1200-3.

Oguntola S, Adeoti ML, Oyemolade TA. Appendicitis: trends in incidence, age, sex, and seasonal variations in South-Western Nigeria; Ann Afr Med. 2010;9(4):213-7.

Akbulut S, Caliskan A, Ekin A, Yagmur Y. Left-sided Acute appendicitis with situs inversus totalis: review of 63 published cases and report of two cases. J Gastrointest Surg. 2010;14(9):1422-8.

Otan E, Akbulut S, Kayaalp C. Amebic acute appendicitis: systematic review of 174 cases. World J Surg. 2013;37(9):2061-73.

Stein GY, Rath-Wolfson L, Zeidman A, Atar E, Marcus O, Joubran S, et al. Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis: Langenbecks Arch Surg. 2012;397(7):1087-92.

Kong VY, Bulajic B, Allorto NL, Handley J, Clarke DL. Acute appendicitis in a developing country. World J Surg. 2012;36(9):2068-73.

Harbrecht BG. Acute appendicitis-not just for the young. Am J Surg. 2011;202(3):286-90.

Anderson JEQ, Bickler SW, Chang DC. Examining a common disease with unknown etiology: trends in epidemiology and surgical management of appendicitis in California, 1995-2009. World J Surg. 2012;36(12):2787-94.

Mallick MS. Appendicitis in pre-school children: a continuing clinical challenge. A retrospective study. Int J Surg. 2008;6(5):371-3.

Ferrarese A, Falcone A, Solej M, Bono D, Moretto P, Dervishi N, et al. Surgeon's clinical evaluation and accuracy of ultrasound in the diagnosis of acute appendicitis: a comparison with intraoperative evaluation. Five years’ experience. Int J Surg. 2016;33(1):45-50.

Laméris W, Randen AV, Go PM, Bouma WH, Donkervoort SC, Bossuyt PMM, et al. Single and combined diagnostic value of clinical features and laboratory tests in acute appendicitis. Acad Emerg Med. 2009;16(9):835-42.

Cardall T, Glasser J, Guss DA. Clinical value of the total white blood cell count and temperature in the evaluation of patients with suspected appendicitis. Acad Emerg Med. 2004;11(10):1021-7.

Wagner JW, McKinney WP, Carpenter JL. Does this patient have appendicitis? JAMA. 1996;276(19):1589-94.

Khan GM, Grillo IA, Abu-Eshy SA, Khan AR. Pathology of the appendix. J Natl Med Assoc. 2000;92(11):533-5.

Altun E, Avci V, Azatçam M. Parasitic infestation in appendicitis. A retrospective analysis of 660 patients and brief literature review. Saudi Med J. 2017;38(3):314-8.

Fleming CA, Kearney DE, Moriarty A. An evaluation of the relationship between Enterobius vermicularis infestation and acute appendicitis in a paediatric population: a retrospective COHORT study. Int J Surg. 2015;18:154-8.