Caecal Gurgling - A new sign in the diagnosis of acute appendicitis and its correlation with intra operative findings

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies, with a lifetime prevalence rate of approximately one in seven. The incidence is 1.5–1.9/1,000 in the male and female population and is approximately 1.4 times greater in men than in women. The diagnosis of acute appendicitis is based purely on clinical history and
examination combined with laboratory investigations such as elevated white cell count.

Aims and Objectives: To examine clinical and laboratory findings of patients with right iliac fossa pain attending general surgery outdoor, indoor, and emergency of BSMCH and the relation between caecal gurgling with acute appendicitis andits correlation with intraoperative findings.

Materials and Methods: This study was a hospital-based cross-sectional analytical study. It was conducted in rural-based tertiary care hospital and medical college with a time frame of about 1½years from acceptance of synopsis. The period of study was from January 2019 to May 2020, in the Department of general surgery, Bankura Sammilani Medical College and Hospital, Bankura.

Results: In Acute Appendicitis, 188(68.1%) patients were APL, and 88(31.9%) patients were BPL. In Normal Appendix, 85(68.5%) patients were APL and 39(31.5%) patient were BPL. Association of SES versusThe final diagnosis was not statistically significant (P=0.9315).

Conclusion: Diagnosis of acute appendicitis is mainly clinical. Keeping in view the results of the present study, we conclude that caecal gurgling is an important positive clinical finding in the diagnosis of acute appendicitis. Incorporating caecal gurgling into Modified Alvarado Scoring System,especially in the patients with a MAS of 5–6 where there is a dilemma whether to operate the patient or not, it aids in our decision-making and thus helps to reduce the rate of negative appendectomies.