Profile of signs and symptoms in mild and advanced acute appendicitis.

The aim of this study was to investigate the relationship between the frequency of common signs and symptoms and the histopathologic findings of resected appendix to identify factors that might be useful for judging the necessity for surgery in patients with acute appendicitis. The association of preoperative clinical characteristics, including age, sex, physical findings, gastrointestinal symptoms, body temperature, and white blood cell count, with histopathologic findings of the appendix was evaluated in 128 patients, who underwent appendectomy for clinical symptoms of acute appendicitis. The frequency of periumbilical pain as the initial symptom was significantly high in patients with catarrhal appendicitis (P < 0.01 versus those with phlegmonous appendicitis, P < 0.01 versus those with gangrenous appendicitis), and vomiting occurred less frequently in these patients (P < 0.05 versus those with phlegmonous appendicitis, P < 0.01 versus those with gangrenous appendicitis). A history of periumbilical pain and vomiting was useful for judging the necessity of appendectomy.