Our Summary

The research paper investigates the impact of delays in the hospital on the rates of appendix rupture (perforation) and complications in patients with acute appendicitis. The study analyzed data from 4,148 patients who underwent appendectomies between 2008 and 2013. The findings showed that the longer a patient waited to go to the hospital after experiencing symptoms, the higher the chance of their appendix rupturing and complications occurring. However, once at the hospital, delays before surgery did not significantly increase the risk of the appendix rupturing or complications arising. But, when the delay in the hospital exceeded 18 hours, the risk of complications increased. Particularly, the risk of postoperative ileus (a lack of movement in the intestines that can cause a blockage) significantly increased. The study concludes that delays in the hospital of up to 18 hours are safe, but beyond that, caution is needed.

FAQs

  1. Does the length of time before seeking medical treatment affect the risk of appendix rupture in acute appendicitis?
  2. Does a delay in surgery once in the hospital increase the risk of appendix rupture or complications?
  3. What is the impact of hospital delays exceeding 18 hours on postoperative complications, particularly postoperative ileus?

Doctor’s Tip

A helpful tip a doctor might tell a patient about appendectomy is to seek medical attention promptly if they are experiencing symptoms of appendicitis, such as abdominal pain, nausea, and fever. Early diagnosis and treatment can help prevent the appendix from rupturing and reduce the risk of complications. It is important not to delay seeking medical help, as timely intervention is crucial for a successful outcome.

Suitable For

Patients with acute appendicitis who experience symptoms such as abdominal pain, nausea, vomiting, and fever are typically recommended for appendectomy. It is important for these patients to seek medical attention promptly to prevent complications such as appendix rupture and postoperative ileus. Additionally, patients who have been diagnosed with appendicitis and are scheduled for surgery should not experience significant delays in the hospital before undergoing the appendectomy to reduce the risk of complications.

Timeline

Before appendectomy:

  1. Patient experiences symptoms of acute appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient may delay seeking medical attention due to uncertainty of the symptoms or fear of surgery.
  3. Patient eventually goes to the hospital and is diagnosed with acute appendicitis through physical examination, blood tests, and imaging studies.
  4. Patient is prepared for surgery, which may include fasting and receiving antibiotics.

After appendectomy:

  1. Patient undergoes appendectomy surgery to remove the inflamed appendix.
  2. Recovery period in the hospital, which may involve pain management, monitoring for complications, and resuming oral intake.
  3. Patient is discharged from the hospital and instructed on post-operative care, including wound care, activity restrictions, and follow-up appointments.
  4. Patient gradually resumes normal activities and diet as they recover from the surgery.
  5. Patient may experience some post-operative complications such as infection, bleeding, or ileus, which may require additional treatment.
  6. Patient eventually fully recovers from the surgery and returns to normal daily activities.

What to Ask Your Doctor

  1. What are the symptoms of appendicitis that I should be aware of?
  2. How soon should I seek medical attention if I suspect I have appendicitis?
  3. What tests will be done to confirm that I have appendicitis?
  4. What are the risks and benefits of undergoing an appendectomy?
  5. How long will the surgery take and what is the recovery process like?
  6. Are there any potential complications that I should be aware of?
  7. How soon after the surgery can I resume normal activities?
  8. Is there anything I should do to prepare for the surgery?
  9. Are there any dietary or lifestyle changes I should make post-surgery?
  10. How often should I follow up with you after the surgery?

Reference

Authors: Jeon BG, Kim HJ, Jung KH, Lim HI, Kim SW, Park JS, Kim KH, Kim ID. Journal: Am Surg. 2016 Jan;82(1):65-74. PMID: 26802860