Objective: Although appendicectomy accounts for the highest number of unnecessary surgical procedures, there is little information on the accuracy of the procedure in Kuwait. Therefore, the objective of this study was to determine the accuracy of pre-operative diagnosis of acute appendicitis and the influence of age, gender and surgical personnel on the rate of normal appendicectomy. Materials and Methods: A retrospective histopathological review of specimens involving ‘acute appendicitis’ in the surgical pathology files of the Mubarak Al-Kabeer Hospital, Kuwait in 1982–1986 and 1992–1996 was carried out. The diagnostic accuracy (DA) was defined as the proportion of specimens in which an inflamed appendix was confirmed microscopically and the negative appendicectomy rate (NAR) was the proportion of appendices that were microscopically normal. Results: The DA was 80 and 84% for 1982–1986 and 1992–1996, respectively. There was a marked decline in the number of females in the second period from 42 to 30%. Females, who accounted for 36% of all cases, comprised 61% of normal appendicectomies with the highest NAR in the 20- to 29-year age group (23.7%). The NAR decreased in the second period from 18.4 to 12.4%. Conclusion: The results show that the clinical diagnostic accuracy of appendicitis in Mubarak Al-Kabeer Hospital is consistent with reports from several centres. However, auditing with routine histopathological examination is still necessary to improve clinical evaluation, particularly in females, many of whom are still subjected to the risks of unnecessary laparotomy.

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