AB166. 81. Adult-onset acute appendicitis as a manifestation of colorectal cancer: a 10-year multi-centre study

Background: Appendicitis is one of the most common surgical causes of acute abdomen with an estimated lifetime risk of 8.6% and 7.6% in male and female respectively. The risk tends to decline above the age of 40, making appendicitis a rare entity and its presence creating a suspicion for tumour. However, association of acute appendicitis and colon cancer hasn’t been fully investigated and this study is designed to ascertain if patients with appendicitis are being investigated for colorectal cancer. This study aims to assess the linkage of acute appendicitis to colorectal cancer and adherence of guidelines for endoscopy post-operatively.

Methods: This is a retrospective observational study conducted on all patients that presented with adult-onset (>40 years of age) acute appendicitis in Tallaght and Naas General Hospital from January 2007 to December 2016. All patients were assessed for demographic factors, length of stay and post-operative complications and post-operative colonoscopy. The timing and positive findings were assessed for each colonoscopy. All the data was recorded in Microsoft Excel and all data was analysed with SPSS v. 24.

Results: Out of the 541 patients who underwent appendectomy for acute appendicitis, 43.4% male and 56.6% females. The average age was 51.2 (range, 40–86 years). The average length of stay was 12.1 (range, 1–127) days. There were 91 (16.8%) patients who underwent post-operative follow-up colonoscopy. Out of the 91 patients, 18 (3.3%) patients had colonoscopy between 6 weeks to 6 months post-operatively whereas 10 (1.8%) patients had colonoscopy between 6–12 months post-operatively.

Conclusions: This study establishes that very few patients undergo colonoscopy after appendectomy. With colorectal cancer on rise, it is mandatory every elderly patient should have colonoscopy post-operatively.

Keywords: Appendicectomy; colonoscopy; elderly; colorectal cancer