Negative Appendicectomies in Young Female Patients with High Clinical  Suspicion of Acute Appendicitis

Authors

  • Umer Naeem Department of General Surgery, Combined Military Hospital Quetta/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Waseem Anwar Department of General Surgery, Combined Military Hospital Quetta/National University of Medical Sciences (NUMS) Pakistan
  • Fatima Farooq Department of General Surgery, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Tariq Mukhtar Farani Department of General Surgery, Combined Military Hospital Quetta/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Danial Yousaf Department of General Surgery, Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Saqlain Department of General Surgery, Combined Military Hospital Sialkot/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-7.11400

Keywords:

Appendicitis, Appendectomy, Laparoscopy.

Abstract

Objective: To determine negative appendicectomies, both open and laparoscopic, in young female patients with high clinical suspicion of acute appendicitis (Alvarado Score ≥7).

Study Design: Quasi-experimental study

Place and Duration of Study: Department of General Surgery, Combined Military Hospitals, Rawalpindi and Quetta Pakistan, from Oct 2021 to Nov 2023.

Methodology: A total of 150 female patients aged between 12 to 30 years, with Alvarado score ≥7 were included in the study. Baseline characteristics were documented. All patients underwent appendicectomy and retrieved appendix was sent to histopathology lab for histopathological diagnosis based on which negative appendicectomies were identified.

Results: In this study, mean age of patients was 21.50±3.16 years. Twenty-eight (18.67%) patients underwent open appendicectomy while 122(81.33%) patients underwent laparoscopic appendicectomy. Composite negative appendicectomy was seen in 37(24.67%) cases. No statistically significant association was found between type of surgery and negative appendicectomy (p=0.595).

Conclusion: In young females, even in the presence of high clinical suspicion, the rate of negative appendicectomies is relatively high.

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References

1. Constantin M, Petrescu L, Mătanie C, Vrancianu CO, Niculescu AG, Andronic O, et al. The vermiform appendix and its pathologies. Cancers 2023; 15(15): 3872.

https;//doi.org/10.3390/cancers15153872

2. Killinger B, Labrie V. The appendix in Parkinson's Disease: From vestigial remnant to vital organ? J Parkinsons Dis 2019; 9(s2): S345-S358. https://doi.org/10.3233/JPD-191703

3. Peeters T, Martens S, D'Onofrio V, Stappers MHT, van der Hilst JCH, Houben B, et al. An observational study of innate immune responses in patients with acute appendicitis. Sci Rep 2020; 10(1): 17352.

https://doi.org/10.1038/s41598-020-73798-3

4. Wickramasinghe DP, Xavier C, Samarasekera DN. The worldwide epidemiology of acute appendicitis: an analysis of the global health data exchange dataset. World J Surg 2021; 45(7): 1999-2008.

https://doi.org/10.1007/s00268-021-06077-5

5. Chaochankit W, Boocha A, Samphao S. Negative appendectomy rate in patients diagnosed with acute appendicitis. BMC Surg 2022; 22(1): 404.

https://doi.org/10.1186/s12893-022-01852-0

6. Naeem MT, Jamil MA, Anwar MI, Raza H, Asad A, Jamil H, et al. Diagnostic accuracy of Alvarado scoring system relative to histopathological diagnosis for acute appendicitis: A retrospective cohort study. Ann Med Surg 2022; 81: 104561.

https://doi.org/10.1016/j.amsu.2022.104561

7. Yale SH, Tekiner H, Yale ES. Signs and syndromes in acute appendicitis: A pathophysiologic approach. World J Gastrointest Surg 2022; 14(7): 727.

https://doi.org/10.4240/wjgs.v14.i7.727

8. Bhangu A. Evaluation of appendicitis risk prediction models in adults with suspected appendicitis. Br J Surg 2020; 107(1): 73-86. https://doi.org/10.1002/bjs.11440

9. Oyewole B, Runkel M, Gordon A, Farkas N. Burden of negative appendectomy at a District General Hospital: a two-year cross-sectional review. Pan Afr Med J 2022; 8: 54.

https://doi.org/10.11604/pamj-cm.2022.8.54.31677

10. Al-Balas H, Al-Saffar RS, Al-Balas M, Al-Wiswasy MK, Salhiyeh AA, Al-Sharqi Y, et al. Unusual histopathological findings in appendectomy specimens with clinical diagnosis of acute appendicitis: A retrospective cohort analysis. Ann MedSurg 2021; 69: 102720.

https://doi.org/10.1016/j.amsu.2021.102720

11. Gupta S, Kolli VS, Da Costa K, Javed S, Ammar A, Rasheed A. A systematic review and meta-regression for validation of the Alvarado score as a tool for predicting acute appendicitis. Ann Med Surg 2023; 85(2): 111-121.

https://doi.org/10.1097/MS9.0000000000000238

12. Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg 2020; 15(1): 27.

https//doi.org/10.1186/s13017-020-00306-3

13. Köhler F, Hendricks A, Kastner C, Müller S, Boerner K, Wagner JC, et al. Laparoscopic appendectomy versus antibiotic treatment for acute appendicitis-a systematic review. Int J Colorectal Dis 2021; 36(10): 2283-2286.

https://doi.org/10.1007/s00384-021-03927-5

14. Gelpke K, Hamminga JTH, van Bastelaar JJ, de Vos B, Bodegom ME, Heineman E, et al. Reducing the negative appendectomy rate with the laparoscopic appendicitis score; a multicenter prospective cohort and validation study. Int J Surg 2020; 79: 257-264.

https://doi.org/10.1016/j.ijsu.2020.04.041

15. Tamini N, Santurro L, Chiappetta MF, Gattuso I, Barbieri C, Fattori L, et al. Morbidity after negative appendectomy: a single-centre experience on 627 cases. Eur J Trauma Emerg Surg 2020; 46(4): 859-864.

https://doi.org/10.1007/s00068-019-01138-w

16. Henriksen SR, Christophersen C, Rosenberg J, Fonnes S. Varying negative appendectomy rates after laparoscopic appendectomy: a systematic review and meta-analysis. Langenbecks Arch Surg 2023; 408(1): 205.

https://doi.org/10.1007/s00423-023-02935-z

17. Timmerman ME, Groen H, Heineman E, Broens PM. The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children. Int J Colorectal Dis 2016; 31(8): 1467-1473.

https://doi.org/10.1007/s00384-016-2614-6

18. Pooria A, Pourya A, Gheini A. Appendicitis: clinical implications in negative appendectomy. Int J Surg Open 2021; 29: 45-49.

https://doi.org/10.1016/j.ijso.2021.01.004

19. Ali Z, Khan MR, Memon RA, UjjanID, Hussain F, Nisar Z. Negative appendectomies are more common in females of reproductive age group. Pak Armed Forces Med J 2021; 71(6): 2011-2014.

https://doi.org/10.51253/pafmj.v6i6.4630

20. Chaochankit W, Boocha A, Samphao S. Negative appendectomy rate in patients diagnosed with acute appendicitis. BMC Surg 2022; 22(1): 404.

https://doi.org/10.1186/s12893-022-01852-0

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Published

29-11-2025

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Section

Original Articles

How to Cite

1.
Naeem U, Muhammad Waseem Anwar, Fatima Farooq, Farani TM, Muhammad Danial Yousaf, Muhammad Saqlain. Negative Appendicectomies in Young Female Patients with High Clinical  Suspicion of Acute Appendicitis. Pak Armed Forces Med J [Internet]. 2025 Nov. 29 [cited 2025 Dec. 6];75(SUPPL-7):S1058-S1061. Available from: https://pafmj.org/PAFMJ/article/view/11400