Causes of Delayed Presentation of Acute Appendicitis and How it Affects Morbidity and Mortality

BACKGROUND: Acute appendicitis is one of the common abdominal emergency and appendectomy is one of the commonest emergency Surgical procedure performed all over the world. OBJECTIVE; To evaluate the different causes of delayed presentation of acute appendicitis MATERIALS & METHODS: This cross sectional study was carried out in Surgical ward of DHQ hospital Timargara Dir. All the patients were subjected to a detailed history, Clinical examination and investigations. RESULTS: It was found that physicians mis-diagnosed 26.08% of the patients, Around 32.17 % of the patients were mismanaged by Quacks. Patients managed by DHQ district Surgeons were about 5.21% and self medications were found in 13.04 % patients. so presentation due to late arrival and refusal by the patient on financial grounds was 13.04%.About 10.43% of our study patients were complicated due to refusal of surgery by the patients themselves after the diagnosis being told to them. CONCLUSION: All the patients with pain right iliac fossa should be suspected of acute appendicitis. Proper work up should be done to exclude the diagnosis of acute appendicitis. If the diagnosis is equivocal, the patient should be kept under observation with regular monitoring of vitals. Early appendectomy should be considered as delaying the procedure has serious implications.