Intestinal obstruction in appendicitis: A retrospective cohort study

Abstract

Background

Appendicitis as a cause of intestinal obstruction is an infrequent condition. The purpose of this study was to define the incidence and frequency of intestinal obstruction, according to the classification of intestinal obstruction secondary to appendicitis, and to characterise their severity.

Methods

A retrospective cohort study analysing all patients operated on for intestinal obstruction secondary to appendicitis within a 15-year period was designed. Continuous and categorical variables including age, gender, time interval between onset of symptoms and diagnosis, C-reactive protein and white blood cells values, type of intestinal obstruction and WSES Sepsis Severity Score, were included.

Results

During the period of study 3626 patients were operated on for appendicitis and 44 cases had associated intestinal obstruction (1.2%). According to the classification of intestinal obstruction in appendicitis, most patients had a mechanical ileus with strangulation (48%) and a WSES Sepsis Severity Score of 3 or less points (77%).

Conclusions

The incidence of intestinal obstruction in appendicitis was higher than expected. These patients have a severe inflammatory response with a WSES Sepsis Severity Score of 3 points. According to the classification of intestinal obstruction in appendicitis, most patients had a mechanical obstruction with strangulation.

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