Background: Advanced appendicitis is a problem in Africa,
and it is a reflection of delayed presentation. Its incidence is about 40-50%
of all cases and this disease is unfortunately associated with a high mortality
of about 0.9 to 4%, certainly higher than in the developed world. Advanced
appendicitis poses a serious challenge to surgeons in poor resource settings
and it is associated with a higher morbidity and mortality.
Objective: To report the outcome of tube-caecostomy in the
prevention of fistula formation after appendicectomy for appendicular mass,
abscess or gangrenous appendix.
Methods: A retrospective study involving all patients
diagnosed with appendix mass, abscess and gangrenous appendix admitted into
Central Hospital Benin City from October 2005 to October 2010. Data was
collated from patient’s case notes, theatre records and ward registers. The
Stamm procedure using a size 24 three-way catheter as a caecostomy tube was
used. The data collected was analyzed as age, mean age, peak age incidence, sex
ratio and percentages.
Results: A total of 14 patients underwent tube caecostomy
during appendicectomy. There were 10(71.4%) males and 6(28.6%) females. The
male-to-female ratio was 2.5:1. The ages of the patients ranged from 14-42
years with a mean age of 28.5 years. Seven (50%) of the cases had wound
infection, and three (21%) had wound dehiscence. Hospital stay ranged from 14
to 33 days with a mean stay of 19.1 days. No serious catheter-related
complications nor residual abscesses were recorded and there were no
mortalities in this study.
Conclusion: Tube caecostomy as a procedure performed for
advanced appendicitis is a favourable alternative to interval appendicectomy,
right hemicolectomy and ileostomy. The latter two procedures require an
experienced surgeon and are fraught with high morbidity and mortality. Future
research should be directed towards carrying out a prospective study comparing
the efficacy of tube-caecostomy with interval appendicectomy.
Author(s) Details
O. Eboreime
Department of Surgery, Central Hospital, Benin City, Edo
State, Nigeria.
Z. I. Asogun
Department of Surgery, Central Hospital, Benin City, Edo
State, Nigeria.
Please see the book here:- https://doi.org/10.9734/bpi/mria/v9/38
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