Correlation between degree of pain at the emergency room and progression of appendicitis based on computed tomography

Ryu, Hyoung Sun; Shin, Su Jeong

J Korean Soc Emerg Med > Volume 29(6); 2018 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2018;29(6): 656-662.

응급실 방문 당시 통증 정도와 computed tomography 기반 충수염 진행 정도와의 상관관계

류형선¹

, 신수정²

¹분당차병원 응급의학과
²구미차병원 응급의학과

Correlation between degree of pain at the emergency room and progression of appendicitis based on computed tomography

Hyoung Sun Ryu¹

, Su Jeong Shin²

¹Department of Emergency Medicine, CHA Bundang Medical Center, Seongnam, Korea
²Department of Emergency Medicine, CHA Gumi Medical Center, Gumi, Korea

Correspondence

Su Jeong Shin ,Tel: 054-450-9700, Fax: 054-450-9967, Email: drjeong79@naver.com,

Received: May 20, 2018; Revised: August 29, 2018 Accepted: October 8, 2018. Published online: December 31, 2018.

ABSTRACT

Objective:
Acute appendicitis is one of the most urgent surgical problems. Several factors have been considered as predictors of perforation, but this study focused on the change in pain pattern. The degree of pain and progression of appendicitis were analyzed assuming that the pain intensity would increase until the perforation and the degree of pain would decrease immediately after the perforation occurred.
Method:
In this study, 385 out of 467 patients, who were diagnosed with appendicitis in a single institution and aged between 15 and 65 years, were reviewed retrospectively. The patients’ pain scores and the diameters of appendices were analyzed along with the accompanying complications. Correlation analysis and a Student’s t-test were performed.
Results:
In patients with complicated appendicitis, the mean numerical rating scale (NRS) was slightly higher than that of simple appendicitis, but there was no significant difference in the absolute value. Only the size of the appendix showed meaningful differences according to the combined computed tomography findings. The NRS distribution or appendiceal size did not correlate with the time duration from symptom onset.
Conclusion:
The appendiceal size tended to increase with progressing appendicitis. No significant correlation was observed between the patient's pain level and complications. The time duration from symptom onset did not show a relationship with the progression of appendicitis.

Key words: Appendicitis; Abdominal pain; Pain measurements