Abstract:

Acute appendicitis is a common surgical emergency, with perforation leading to increased morbidity and mortality. The length-to-diameter ratio of the appendix may be considered a predictor of perforation risk. This study aims to evaluate the correlation between this ratio and the incidence of appendicular perforation. This research aims to study the correlation between the appendix length/diameter ratio to its incidence of perforation. A retrospective study was conducted on patients undergoing appendectomy from March 2022 to August 2024. A total of 120 patients were recruited in this study. Patient data, including demographics, histopathological findings, and radiological measurements, were analyzed. Patients were grouped into perforated and non-perforated appendicitis groups. Statistical analyses, including Chi-square tests and logistic regression, were performed to assess the association between appendix length/diameter ratio and perforation risk. Ethical approval was obtained from the institutional ethics committee. Among 120 patients, 65 (54.2%) were male, and 55 (45.8%) were female, with a mean age of 28.1 ± 7.4 years. Perforation was identified in 18 (15%) cases. Patients with a length/diameter ratio ≤10 had a significantly higher perforation rate (14/56, 25%) compared to those with a ratio >10 (4/64, 6.3%) (p<0.01). Logistic regression showed that a ratio ≤10 was an independent predictor of perforation (OR: 4.1, 95% CI: 1.9-8.5, p<0.001). A lower appendix length/diameter ratio significantly increases the risk of perforation in acute appendicitis. Including this parameter in preoperative radiological assessments may improve early diagnosis and improve surgical decision-making, ultimately reducing complications associated with perforated appendicitis.

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