Negative appendectomy rate during 5 years in Modarres Hospital of Tehran, Iran, and correlation with imaging

Introduction: Appendicitis is the most common emergency surgical admission regardless of the age group. In case of delay in diagnosis, serious complications may occur, needing immediate actions. Complications of acute appendicitis like perforation, peritonitis, and sepsis are to justify massive negative appendectomies. In this study, it has been tried to collect data about negative appendectomy during last 5 years in Modarres hospital, Shahid Beheshti University of Medical sciences, Tehran, Iran, based on demographics and correlation with diagnostic studies before operation. This study is important in terms of economy and health care aspects. Methods: Data were collected about all patients appendectomized during 5 years between 2012 and 2017 at Modarres hospital. There were 1454 records, of which 108 records were excluded from the study due to the lack of enough data, interval appendectomy, and clean appendectomy. Finally, end 1346 appendectomies were assessed. Results: There were 275 (20.4%) and 1071 (79.6%) negative appendectomy and suppurative appendicitis, respectively. Preoperative ultrasonography (US) was performed on 753 (56.0%) patients, of which 472 (62.7%) and 281 (37.3%) cases were coordinated with and different from pathologic records, respectively. Preoperative computed tomography (CT) scan was performed for 316 (23.5%) patients, which matched and differed pathologic records in 280 (88.6%) and 36 (11.4%) cases, respectively. Conclusion: Diagnosis of appendicitis should still mainly be based on history, and clinical and laboratory data.