Patterns of appendicitis at a forward-deployed United States Army Hospital: the Korea experience(2)(2)

Abstract

Appendicitis is both a common surgical condition in a young military active duty population and a diagnosis that is notoriously easy to miss. We reviewed all cases of appendicitis that presented to the 121st General Hospital, which is an army facility in Seoul, South Korea, during an 18-month period. Our patient population consisted of 37,000 soldiers as well as dependants and other patients eligible for care. Of 79 patients operated on for suspected acute appendicitis, 60 (76%) had either acute suppurative or perforated appendicitis. The appendix was normal in 16 patients (20%), whereas 3 patients (4%) had a normal appendix with other surgical pathology. We found a perforation rate of 24%, and of these patients, 53% had prior visits to a health care provider in which an incorrect diagnosis or no treatment was given. Only 3 patients with simple acute appendicitis had been previously seen (7%). Patients were transported to the hospital in different ways, but we were unable to find any correlation among modes of transport to the hospital and perforation rates. We believe that timely diagnosis and referral for appendicitis could be improved through focused education of all primary care providers on this disorder.