Appendicectomy Prevalences in South African Adolescents

Ar, Walker; Walker, B.F.; Duvenhage, A; Jones, Jody; Ncongwane, J; Segal, I

doi:10.1159/000198762

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Faecal pH was unchanged by the bran, an observation also noted by Walker et al (1979) in studies of African schoolchildren. Faecal pH is largely determined by fermentation of carbohydrate by the anaerobic flora of the large intestine and it might have been expected that the addition of a significant amount of fermentable carbohydrate to the diet of these subjects would have lowered pH.…”

Section: Faecal Compositionsupporting

confidence: 71%

The effect of age, sex and level of intake of dietary fibre from wheat on large-bowel function in thirty healthy subjects

et al. 1986

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1. To evaluate the effect of age, sex and level of intake on the colonic response to wheat fibre, thirty healthy volunteers aged 17-62 years (nineteen men, eleven women) recruited from a local industry, were divided into four groups and given a controlled diet for two 3-week periods. The diet contained white bread during one period or one of four different amounts of bran-enriched wholemeal bread during the other (30, 60, 110, 170 g/d).2. Wide variation was observed between subjects in stool weight on the basal diet and in response to wheat fibre. Stepwise regression analysis showed that the variation in stool weight was significantly related to sex (t 4.0, P < 0.001) but not to age, height, weight or energy:fibre intakes on the basal diet. Stool weight in men (162 (SE 11) g/d) was approximately double that in women (83 (SE 11) g/d). Transit time and stool weight were closely related and the effect of sex on stool weight could be explained entirely by differences in transit.3. The increase in stool weight with fibre was significantly related to dose (t 4.18, P < 0.001) with approximately 1 g non-starch polysaccharides (the main component of dietary fibre) increasing stool weight by 5 g/d. Smaller increases in stool weight were seen in females, persons with initially low stool weights and small people.4. Faecal carbohydrate excretion increased with the addition of bran mainly due to increased amounts of cellulose and pentose (arabinose + xylose), whilst digestibility of dietary non-starch polysaccharide fell from 77.6 (SE 2.3)% on the white bread diet to 65.6 (SE 2.4)% with the added bran ( t 7.4, P < 0.01, n 26). 5.Faecal pH was more acid in men than in women and was related to methane production. Methane producers had higher faecal pH than non-producers (7.06 (SE 0.1 1) v. 6.65 (SE O.I)), lower stool weight (g/d; 93 (SE 12) v. 156 (SE 13)) and slower transit times (h; 84.6 (SE 11.7) v. 48.6 (SE 6.6)).6. These studies show that, when on similar diets, women have much lower stool weights and slower transit times than men. Furthermore, within the range of amounts of wheat fibre used in this and other published work, stool weight increases in linear proportion to the dose of ftbre added to the diet. Methane excretion in breath is associated in this group of subjects with slow transit time and high faecal pH.

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Section: Faecal Compositionsupporting

confidence: 71%

The effect of age, sex and level of intake of dietary fibre from wheat on large-bowel function in thirty healthy subjects

et al. 1986

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“…According to a South African study conducted in 1982, 2 10.5% of white South Africans had an appendicectomy and the figures among urban and rural blacks was 0.7% and 0.6%, respectively. The importance of early recognition and treatment of perforated appendicitis has been emphasised, so in equivocal cases surgeons felt obliged to operate without delay.…”

Section: Discussionmentioning

confidence: 99%

A Clinicopathological Review of 324 Appendices Removed for Acute Appendicitis in Durban, South Africa: A Retrospective Analysis

Chamisa

2009

annals

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INTRODUCTION Acute appendicitis remains a common surgical condition and the importance of specific elements in the clinical diagnosis remain controversial. A variety of neoplastic and inflammatory conditions mimic acute appendicitis. The purpose of this study was to determine the presenting pattern of acute appendicitis and to review the pathological diagnosis. PATIENTS AND METHODS This is a retrospective analysis of 324 patients who had appendicectomy for acute appendicitis at Prince Mshiyeni Memorial Hospital (Natal, South Africa) during the period January 2002 to December 2004. Patient demographics, clinical features, white cell count, operative findings, outcome and histology results were recorded on a special patient proforma. RESULTS A total of 371 patients underwent appendicectomy during this period and 324 (M:F, 3.6:1) were available for analysis. The majority of our patients were in the second decade (43.1%) with only 29.3% presenting within 24 h of onset of symptoms. The most common symptoms were abdominal pain (100%), vomiting (57.4%) and anorexia (49.0%). Generalised and localised abdominal tenderness were present in 62.0% and 19.4% of patients, respectively. Pyrexia was noted in 41.0%. Localised and generalised peritonitis were present in 26.4% and 14.0%, respectively. The most common incisions were lower midline laparotomy (47.2%) and gridiron (37.3%). The negative appendicectomy rate was 17.0%. Acute appendiceal inflammation and gangrenous appendicitis was present in 36.1% and 9.6%, respectively. The perforation rate was 34.0% and there was a direct correlation with delayed presentation. There were no patients with carcinoid tumour or adenocarcinoma. Parasites and other associated conditions were seen in 8.6% of cases. Postoperative complications included: wound sepsis (25.3%), prolonged ileus (6.2%), peritonitis (4.6%) and chest infection (3.4%). Four patients died (1.2%) all from the perforated group. CONCLUSIONS Our patients present late with advanced disease and complications. All surgeons should bear in mind the possibility of parasitic infestations mimicking acute appendicitis and the presence of significant unusual histological findings in our setting justifies routine histopathological examination of appendices.CHAMISA

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“…Scarcity of diverticular disease among urban Blacks is therefore undoubted. It must be added that among these people, other bowel diseases, including appendicits [23], ulcerative colitis [24] and colon cancer [25], are also rare or very uncommon. Fur thermore.…”

Section: Discussionmentioning

confidence: 99%

Diverticular Disease in Urban Africans in South Africa

Segal¹,

Walker²

1982

Digestion

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At Baragwanath Hospital, Johannesburg, South Africa, during a 3-year period diverticular disease was diagnosed in 42 Black patients (16 men, 26 women), from an urban population approaching 1,5 million. Patients presented mainly with rectal bleeding, abdominal mass or pain. Of average age 62 years, all were among the more privileged. The persisting very low frequency of the disease, which is in consonance with low frequencies of other bowel diseases (appendicitis, ulcerative colitis, colon cancer), is deemed valid. The mean daily dietary fibre intake, 26.5 ± 8.5 g, was higher than that of local Whites, 22.4 ± 6.0 g, but significantly less than that of a sex-age matched urban Black control group, 32.5 ± 11.4 g. Although a measure of westernization of diet has obviously occurred, its extent, also the period of exposure, would seem to have been insufficient to have evoked significant rises in the occurrence of diverticular disease.

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Appendicectomy Prevalences in South African Adolescents

Cited by 7 publications

References 8 publications

The effect of age, sex and level of intake of dietary fibre from wheat on large-bowel function in thirty healthy subjects

The effect of age, sex and level of intake of dietary fibre from wheat on large-bowel function in thirty healthy subjects

A Clinicopathological Review of 324 Appendices Removed for Acute Appendicitis in Durban, South Africa: A Retrospective Analysis

Diverticular Disease in Urban Africans in South Africa

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