Association of Delayed Presentation with Perforation Rate and Postoperative Complications in Acute Appendicitis
DOI:
https://doi.org/10.53350/Annalspakmed.2.1.33Keywords:
Acute appendicitis; Appendiceal perforation; Delayed presentation; Postoperative complications; Surgical site infection; AppendectomyAbstract
Background: Acute appendicitis is a common surgical condition around the world. A delay in presenting to a medical facility may contribute to appendiceal perforation and worse postoperative outcomes. In low- and middle-income countries, delayed presentation is still a common clinical issue, and may be associated with disease severity and postoperative complications.
Aim: To assess the relationship between delayed presentation and appendiceal perforation and postoperative complications in acute appendicitis.
Methods: This cross-sectional analytical study was performed in the Department of General Surgery, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh a tertiary care teaching hospital in Pakistan from 1st August 2025 to 31st January 2026. Consecutive sampling of 120 patients, aged 15-60 years, who presented with acute appendicitis and were treated by appendectomy was done. Early presenters (≤24 hours) and delayed presenters (>24 hours) were defined according to the time elapsed from symptom onset to presentation. The presence of perforation at surgery and postoperative complications such as wound infection, fever, ileus, intra-abdominal collection, wound dehiscence and length of hospital stay were noted. SPSS version 26.0 was used for data analysis.
Results: Seventy (58.3%) patients presented more than 24 hours after symptom onset. A total of 39 patients (32.5%) had appendiceal perforation and this was significantly higher (p<0.001) in delayed presenters (47.1%) than in early presenters (12%). Complications after surgery were more common in delayed presenters (38.6%) than early presenters (16%) [p=0.008]. The mean length of hospital stay was also longer in delayed presenters 5.1±1.9 days than early presenters 2.9±1.2 days (p<0.001).
Conclusion: Late presentation with acute appendicitis is strongly linked to high perforation rate and postoperative complications. Early diagnosis and prompt surgical intervention are crucial to minimise complications and optimise patient outcomes.
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Copyright (c) 2026 TAYYABA RASHEED, FARHAN ALI, MUHAMMAD NUMAN TAHIR, KALSOOM KALHORO, TARIQ HUSSAIN
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