Phlegmonous appendicitis as a variant of uncomplicated appendicitis

Abstract Acute appendicitis is the most common cause of surgical acute abdomen, and its classification into uncomplicated, phlegmonous, and complicated forms is crucial for guiding treatment strategies. This study aims to compare the preoperative laboratory findings and postoperative outcomes of phl...

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Main Authors: Tezcan Akın, Hüseyin Fahri Martlı, Eda Şahingöz, Birkan Birben, Sadettin Er, Ayşe Çiftçi, Hayriye Tatlı Doğan, Mesut Tez
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-85904-4
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author Tezcan Akın
Hüseyin Fahri Martlı
Eda Şahingöz
Birkan Birben
Sadettin Er
Ayşe Çiftçi
Hayriye Tatlı Doğan
Mesut Tez
author_facet Tezcan Akın
Hüseyin Fahri Martlı
Eda Şahingöz
Birkan Birben
Sadettin Er
Ayşe Çiftçi
Hayriye Tatlı Doğan
Mesut Tez
author_sort Tezcan Akın
collection DOAJ
description Abstract Acute appendicitis is the most common cause of surgical acute abdomen, and its classification into uncomplicated, phlegmonous, and complicated forms is crucial for guiding treatment strategies. This study aims to compare the preoperative laboratory findings and postoperative outcomes of phlegmonous appendicitis with uncomplicated and complicated appendicitis. This retrospective cohort study included 1,441 patients who underwent appendectomy between January 2019 and March 2021 at Ankara Bilkent City Hospital. Patients were classified based on histopathological findings into four groups: normal appendix, uncomplicated appendicitis, phlegmonous appendicitis, and complicated appendicitis. Preoperative laboratory values, postoperative complications, and length of hospital stay were analyzed. The distribution of patients was as follows: Group A (normal appendix, 7.6%), Group B (uncomplicated appendicitis, 59.8%), Group C (phlegmonous appendicitis, 17.6%), and Group D (complicated appendicitis, 15%). Phlegmonous appendicitis exhibited significantly higher leukocyte counts and appendix diameters compared to uncomplicated appendicitis but had lower CRP values than complicated appendicitis. The median hospital stay was similar for Groups A, B, and C (1 day) but significantly longer for Group D (2.1 days, p < 0,001). Complication rates were highest in Group D (24.1%) compared to the other groups. While phlegmonous appendicitis shares some clinical and laboratory characteristics with complicated appendicitis, its postoperative outcomes align more closely with those of uncomplicated appendicitis. This suggests that phlegmonous appendicitis may be more accurately classified as a variant of uncomplicated appendicitis, emphasizing the need for consistent classification to improve treatment strategies and patient outcomes.
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spelling doaj-art-874cc69ca853420aa3edb9d0cc04b2342025-02-09T12:37:54ZengNature PortfolioScientific Reports2045-23222025-02-011511710.1038/s41598-025-85904-4Phlegmonous appendicitis as a variant of uncomplicated appendicitisTezcan Akın0Hüseyin Fahri Martlı1Eda Şahingöz2Birkan Birben3Sadettin Er4Ayşe Çiftçi5Hayriye Tatlı Doğan6Mesut Tez7Department of Surgery, Bilkent City HospitalDepartment of Surgery, Bilkent City HospitalDepartment of Surgery, Bilkent City HospitalDepartment of Surgery, Etlik City HospitalDepartment of Surgery, Bilkent City HospitalDepartment of Pathology, Bilkent City HospitalDepartment of Pathology, Bilkent City HospitalDepartment of Surgery, Bilkent City HospitalAbstract Acute appendicitis is the most common cause of surgical acute abdomen, and its classification into uncomplicated, phlegmonous, and complicated forms is crucial for guiding treatment strategies. This study aims to compare the preoperative laboratory findings and postoperative outcomes of phlegmonous appendicitis with uncomplicated and complicated appendicitis. This retrospective cohort study included 1,441 patients who underwent appendectomy between January 2019 and March 2021 at Ankara Bilkent City Hospital. Patients were classified based on histopathological findings into four groups: normal appendix, uncomplicated appendicitis, phlegmonous appendicitis, and complicated appendicitis. Preoperative laboratory values, postoperative complications, and length of hospital stay were analyzed. The distribution of patients was as follows: Group A (normal appendix, 7.6%), Group B (uncomplicated appendicitis, 59.8%), Group C (phlegmonous appendicitis, 17.6%), and Group D (complicated appendicitis, 15%). Phlegmonous appendicitis exhibited significantly higher leukocyte counts and appendix diameters compared to uncomplicated appendicitis but had lower CRP values than complicated appendicitis. The median hospital stay was similar for Groups A, B, and C (1 day) but significantly longer for Group D (2.1 days, p < 0,001). Complication rates were highest in Group D (24.1%) compared to the other groups. While phlegmonous appendicitis shares some clinical and laboratory characteristics with complicated appendicitis, its postoperative outcomes align more closely with those of uncomplicated appendicitis. This suggests that phlegmonous appendicitis may be more accurately classified as a variant of uncomplicated appendicitis, emphasizing the need for consistent classification to improve treatment strategies and patient outcomes.https://doi.org/10.1038/s41598-025-85904-4Acute appendicitisPhlegmonous appendicitisComplicatedUncomplicated
spellingShingle Tezcan Akın
Hüseyin Fahri Martlı
Eda Şahingöz
Birkan Birben
Sadettin Er
Ayşe Çiftçi
Hayriye Tatlı Doğan
Mesut Tez
Phlegmonous appendicitis as a variant of uncomplicated appendicitis
Scientific Reports
Acute appendicitis
Phlegmonous appendicitis
Complicated
Uncomplicated
title Phlegmonous appendicitis as a variant of uncomplicated appendicitis
title_full Phlegmonous appendicitis as a variant of uncomplicated appendicitis
title_fullStr Phlegmonous appendicitis as a variant of uncomplicated appendicitis
title_full_unstemmed Phlegmonous appendicitis as a variant of uncomplicated appendicitis
title_short Phlegmonous appendicitis as a variant of uncomplicated appendicitis
title_sort phlegmonous appendicitis as a variant of uncomplicated appendicitis
topic Acute appendicitis
Phlegmonous appendicitis
Complicated
Uncomplicated
url https://doi.org/10.1038/s41598-025-85904-4
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