Impact of Family History on Acute Appendicitis – An Iraqi Study at Baghdad Teaching Hospital


  • Tabarek Yaseen College of Medicine, University of Baghdad, Baghdad, Iraq.
  • Zahraa Qais College of Medicine, University of Baghdad, Baghdad, Iraq.
  • Zahraa Abass College of Medicine, University of Baghdad, Baghdad, Iraq.



Risk factor, Appendectomy, Acute Appendicitis, Family History, Emergency


Background: Appendicitis is one of the most common causes of the acute abdomen worldwide, but many patients present with atypical signs and symptoms. The study aimed to evaluate the impact of positive family history in the diagnosis of appendicitis in a limited diagnostic setting.

Methods: Gender matched case control study of ratio (1:2) was carried out from July 2016 to September 2016 with a sample size of 300 patients. Cases were patients presented in surgical department with acute abdominal pain diagnosed as having appendicitis for whom appendectomy was performed, while controls were hospital based with other abdominal problems. Data was collected using a questionnaire. Primary analysis was a Chi square (?2) test and the calculation of odds ratio (OR) for the association between final diagnosis of appendicitis and family history.

Results: Females were 55% in both groups. Cases were younger than controls (27.05± 12.58 vs. 42.43±17.39 years). Positive family history of appendectomy was higher among cases (66%) than controls (31.5%). The diagnosis of acute appendicitis was 3.8 times higher among those with positive family history of appendectomy and abdominal pain, with a sensitivity of 66% and a specificity of 66.4%. Cases with more than one relative with family history of appendectomy, increased suspicion by 13 times when compared to those without family history.

Conclusion: Positive family history of appendectomy in patients with acute abdominal pain and more than one relative with history of appendicitis can be considered as important parameters in the diagnosis of appendicitis in limited diagnostic setting.


Metrics Loading ...

Author Biography

Tabarek Yaseen, College of Medicine, University of Baghdad, Baghdad, Iraq.

Tabarek Yaseen Hameed is sixth year medical student of the College of Medicine, Baghdad University, Baghdad, Irak, of a six-year program. He was one of the ten medical students invited as speaker at the 15th Scientific Conference of the College of Medicine, University Baghdad. He was ranked among the top five of his peer medical students and, in addition, was ranked the third at a national level in secondary school.


Williams NS, Bailey H, Bulstrode CJ, Love RM, O'Connell PR. Bailey & Love's Short Practice of Surgery. 25th ed. London: CRC Press; 2008.

Pieper R, Kager L. The incidence of acute appendicitis and appendectomy. An epidemiological study of 971 cases. Acta Chir Scand. 1982;148(1):45-9.

Heydari A, Zeydi AE. Can Family History Be Used As a Predictor in Patients with Suspected Acute Appendicitis at the Emergency Department?. Bull Emerg Trauma. 2014 Apr;2(2):99-100.

Gwynn LK. The diagnosis of acute appendicitis: clinical assessment versus computed tomography evaluation. J Emerg Med. 2001 Aug;21(2):119-23.

Buckius MT, McGrath B, Monk J, Grim R, Bell T, Ahuja V. Changing epidemiology of acute appendicitis in the United States: study period 1993–2008. J Surg Res. 2012 Jun 15;175(2):185-90. doi: 10.1016/j.jss.2011.07.017. Epub 2011 Aug 9.

Barlas Sulu. Demographic and Epidemiologic Features of Acute Appendicitis. In: Lander A, editor. Appendicitis – A Collection of Essays from Around the World. Rijeka: InTech; 2012. p. 169-178.

Ergul E, Ucar AE, Ozgun YM, Korukluoglu B, Kusdemir A. Family history of acute appendicitis. J Pak Med Assoc. 2008 Nov;58(11):635-37.

Harbrecht BG, Franklin GA, Miller FB, Smith JW, Richardson JD. Acute appendicitis - not just for the young. Am J Surg. 2011 Sep 30;202(3):286-90.

Nitoń T, Górecka-Nitoń A. [Usefulness of imaging examinations in preoperative diagnosis of acute appendicitis]. Wiad Lek. 2014;67(4):548-53. Polish.

Murphy EEK, Berman L. Clinical Evaluation of Acute Appendicitis. Clin Pediatr Emerg Med. 2014 Sep 30;15(3):223-30.

Flum DR, McClure TD, Morris A, Koepsell T. Misdiagnosis of appendicitis and the use of diagnostic imaging. J Am Coll Surg. 2005 Dec;201(6):933-9.

Papandria D, Goldstein SD, Rhee D, Salazar JH, Arlikar J, Gorgy A, et al. Risk of perforation increases with delay in recognition and surgery for acute appendicitis. J Surg Res. 2013 Oct;184(2):723-9. doi: 10.1016/j.jss.2012.12.008. Epub 2012 Dec 27.

Althoubaity FK. Suspected acute appendicitis in female patients. Trends in diagnosis in emergency department in a University Hospital in Western region of Saudi Arabia. Saudi Med J. 2006 Nov;27(11):1667-73.

Webb EM, Nguyen A, Wang ZJ, Stengel JW, Westphalen AC, Coakley FV. The negative appendectomy rate: who benefits from preoperative CT?. Am J Roentgenol. 2011 Oct;197(4):861-6.

Seetahal SA, Bolorunduro OB, Sookdeo TC, Oyetunji TA, Greene WR, Frederick W, et al. Negative appendectomy: a 10-year review of a nationally representative sample. Am J Surg. 2011 Apr;201(4):433-7.

Shimi SM. Appendicitis and Appendicectomy. In: Elgeidie A, editor. Updated Topics in Minimally Invasive Abdominal Surgery. Rijeka: InTech; 2011. p. 137-156.

Chamisa I. What Is the Role of Conservative Antibiotic Treatment in Early Appendicitis? In: Lander A, editor. Appendicitis – A Collection of Essays from Around the World. Rijeka: InTech; 2012. p. 95-106.

Kumar V, Abbas AK, Aster JC. Robbins Basic Pathology. Elsevier Saunders .9th ed. Philadelphia: Elsevier Saunders; 2013.

Sarsu SB, Yılmaz ŞG, Bayram A, Denk A, Kargun K, Sungur MA. Polymorphisms in the IL-6 and IL-6R receptor genes as new diagnostic biomarkers of acute appendicitis: a study on two candidate genes in pediatric patients with acute appendicitis. Ital J Pediatr. 2015 Dec 29;41:100.

Arlt A, Bharti R, Ilves I, Häsler R, Miettinen P, Paajanen H, et al. Characteristic changes in microbial community composition and expression of innate immune genes in acute appendicitis. Innate Immun. 2015 Jan;21(1):30-41. Epub 2013 Dec 11.

Basta M, Morton NE, Mulvihill JJ, Radovanović Z, Radojicić C, Marinković D. Inheritance of acute appendicitis: familial aggregation and evidence of polygenic transmission. Am J Hum Genet. 1990 Feb;46(2):377-82.

Andersson N, Griffiths H, Murphy J, Roll J, Serenyi A, Swann I, et al. Is appendicitis familial?. Br Med J. 1979 Sep 22;2(6192):697-8.

Petroianu A. Acute Appendicitis – Propedeutics and Diagnosis. In: Khatami M, editor. Inflammatory Diseases - Immunopathology, Clinical and Pharmacological Bases. Rijeka: InTech; 2012. p. 171-200.

Gauderer MW, Crane MM, Green JA, DeCou JM, Abrams RS. Acute appendicitis in children: the importance of family history. J Pediatr Surg. 2001 Aug;36(8):1214-7.

Drescher MJ, Marcotte S, Grant R. Family history is a predictor for appendicitis in adults in the emergency department. West J Emerg Med. 2012 Dec;13(6):468-71.

Brender JD, Marcuse EK, Weiss NS, Koepsell TD. Is childhood appendicitis familial?. Am J Dis Child. 1985 Apr;139(4):338-40.

Hiraiwa H, Umemoto M, Take H. Prevalence of appendectomy in Japanese families. Acta Paediatr Jpn. 1995 Dec;37(6):691-3.

Shperber Y, Halevy A, Oland J, Orda R. Familial retrocaecal appendicitis. J R Soc Med. 1986 Jul; 79(7): 405–406.



How to Cite

Yaseen, T., Qais, Z., & Abass, Z. (2018). Impact of Family History on Acute Appendicitis – An Iraqi Study at Baghdad Teaching Hospital. International Journal of Medical Students, 6(2), 47–51.



Original Article