Acute appendicitis is one of the most frequent causes of acute abdomen requiring emergency surgical intervention. It occurs due to obstruction of the appendiceal lumen, commonly caused by fecaliths, lymphoid hyperplasia, or rarely foreign bodies and tumors. This obstruction leads to bacterial proliferation, inflammation, and eventually ischemia or perforation if untreated. Patients typically present with periumbilical pain that later localizes to the right lower quadrant, associated with nausea, vomiting, anorexia, and fever. Clinical examination often reveals tenderness at McBurney’s point along with guarding or rebound tenderness. Despite advancements in imaging modalities such as ultrasonography and computed tomography, diagnosis of acute appendicitis remains largely clinical. Early diagnosis and surgical management are crucial to reduce complications. Appendectomy remains the definitive treatment and can be performed either through an open or laparoscopic approach. Surgical outcomes generally depend on the timing of diagnosis, severity of inflammation, and presence of complications. This study aims to analyze the clinical presentation and surgical outcomes of patients presenting with acute appendicitis in a tertiary care hospital.

This is a Prospective observational study was conducted in the Department of General Surgery, tertiary care teaching hospital over a period of 12 months. Sample Size 120 patients diagnosed with acute appendicitis. Inclusion Criteria • Patients aged 15–65 years • Clinically and radiologically diagnosed acute appendicitis • Patients undergoing appendectomy Exclusion Criteria • Appendicular mass managed conservatively • Interval appendectomy cases • Patients unfit for surgery Data Collection Data were collected using a structured proforma including: • Demographic characteristics • Clinical symptoms and signs • Laboratory investigations • Radiological findings • Type of surgery performed • Operative findings • Postoperative complications • Length of hospital stay Surgical Procedure Patients underwent either open appendectomy or laparoscopic appendectomy depending on surgeon preference and patient condition. Statistical Analysis Data were analyzed using descriptive statistics and expressed as frequencies, percentages, and mean values.

Table 1: Age Distribution of Patients Age Group (years) Number of Patients Percentage 15–25 42 35% 26–35 36 30% 36–45 22 18.3% 46–55 12 10% 56–65 8 6.7% Total 120 100% Table 2: Gender Distribution Gender Number of Patients Percentage Male 70 58.3% Female 50 41.7% Table 3: Clinical Presentation Symptom/Sign Number of Patients Percentage Right lower abdominal pain 120 100% Nausea/Vomiting 94 78.3% Fever 75 62.5% Anorexia 68 56.7% Rebound tenderness 82 68.3% Table 4: Operative Findings Operative Finding Number Percentage Inflamed appendix 78 65% Gangrenous appendix 20 16.7% Perforated appendix 14 11.7% Appendicular abscess 8 6.6% Table 5: Surgical Outcomes Outcome Number Percentage Uneventful recovery 107 89.2% Wound infection 8 6.7% Intra-abdominal abscess 3 2.5% Prolonged ileus 2 1.6%

Acute appendicitis remains one of the most common causes of acute abdominal pain requiring emergency surgery. Early diagnosis and timely intervention are critical to prevent complications. In this study, the majority of patients were in the 15–35-year age group, which is consistent with previous studies showing higher incidence among young adults. A male predominance was also observed, which aligns with findings reported in several epidemiological studies. The most common presenting symptom was right lower abdominal pain, observed in all patients. Other symptoms such as nausea, vomiting, and fever were also frequently reported. These findings correspond with the classical clinical presentation described in the literature. Operative findings revealed that the majority of patients had an inflamed appendix, while a smaller proportion presented with gangrene or perforation. Delayed presentation was often associated with complicated appendicitis. Postoperative complications occurred in approximately 10% of cases, with wound infection being the most common complication. This is comparable to other studies where wound infection rates ranged between 5% and 12%. Overall, the surgical outcomes were favorable, with most patients recovering without complications. Early surgical intervention contributed to reduced morbidity and shorter hospital stay.

Acute appendicitis is a common surgical emergency predominantly affecting young adults. Right lower abdominal pain remains the most consistent presenting symptom. Early diagnosis and prompt surgical management result in favorable outcomes with minimal postoperative complications. Awareness of clinical presentation and timely intervention are essential for improving patient outcomes.

1. Charles McBurney. Experience with early operative interference in cases of disease of the vermiform appendix. Ann Surg. 1889;10:38–43. 2. David C Flum. Acute appendicitis—appendectomy or the antibiotics first strategy. N Engl J Med. 2015;372:1937–43. 3. Paulina Salminen, et al. Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis. JAMA. 2015;313:2340–48. 4. Steven M Strasberg, et al. Clinical diagnosis and management of appendicitis. Surg Clin North Am. 2014;94:1–12. 5. Michael Andersson. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004;91:28–37. 6. Humes DJ, Simpson J. Acute appendicitis. BMJ. 2006;333(7567):530–534. 7. Andersson RE, Hugander A, Thulin AJ. Diagnostic value of disease history, clinical presentation and inflammatory parameters in appendicitis. World J Surg. 1999;23(2):133–140. (International Surgery Journal) 8. Sartelli M, Baiocchi GL, Di Saverio S, et al. Prospective observational study on acute appendicitis worldwide (POSAW). World J Emerg Surg. 2018;13:19. (International Surgery Journal) 9. Bhangu A, Søreide K, Di Saverio S, et al. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015;386(10000):1278–1287. 10. Nshuti R, Kruger D, Luvhengo TE. Clinical presentation of acute appendicitis in adults. Int J Emerg Med. 2014;7:12. (PMC) 11. Alhamdani A, Al-Mousawi H, Al-Saadi R. Clinical presentation of acute appendicitis: a prospective study. Int J Surg. 2018;54:254–258. (International Surgery Journal) 12. Kong VY, Oosthuizen GV, Clarke DL. The clinical utility of migratory right iliac fossa pain in acute appendicitis. S Afr J Surg. 2015;53(1):15–18. (International Surgery Journal) 13. Yang E, Kahn D, Cook C. Acute appendicitis in South Africa: a systematic review. S Afr J Surg. 2015;53:31–38. (International Surgery Journal) 14. Lubega R, Kigula S, Ssekabira U. Risk factors for surgical site infection. World J Surg. 2017;41(9):2314–2320. (International Surgery Journal) 15. Mwaikombo K, Msuya S, Mcharo C, et al. Clinical presentation and outcomes in Tanzania. East Afr J Surg. 2017;22:34–39. (International Surgery Journal) 16. Tony M, Udo R, Ekanem E. Acute appendicitis in a Nigerian tertiary hospital. Ann Afr Surg. 2019;16(2):112–117. (International Surgery Journal) 17. Chandrasekaran TV. Acute appendicitis. Ann R Coll Surg Engl. 2014;96(6):439–444. (ScienceDirect) 18. Afuwape OO, Ayandipo OO, Soreide K. Pattern of presentation and management outcomes. J Clin Sci. 2018;15(4):1–6. (Lippincott Journals) 19. Humes DJ, Simpson J. Clinical features and diagnosis of appendicitis. BMJ. 2006;333:530–534.