Bahrain Medical Bulletin, Vol. 38, No. 4, December 2016 219 Acute appendicitis is possibly the most frequent reason for admission to any surgical unit worldwide. Approximately 5% to 8% of the population in Western countries would have appendicitis sometime during their life, with a peak incidence between 10 and 30 years of age 1 . The clinical presentation of periumbilical pain radiating to the right lower quadrant followed by anorexia and tenderness are unfortunately not a constant feature of acute appendicitis and usually present only in 37% to 53% of patients. The symptoms could be the initial A Clinicopathological Study of Emergency Appendectomy Mohammed Zourob, Jordanian Board, MRCS* Suhail Baithun, MBCHB, FRCPath** Francis O Cunningham, BChBAO, FRCSI*** Mirza Faraz Saeed, FICS, MS**** Martin T Corbally, FRCS, MRCPI***** Mina Girgis, MBBCh, MRCS**** Mohamed Al Hamar, MD******* Khalid Al-Sindi, MIAC, FRCPath******** Background: Acute appendicitis is one of the most frequent reasons for admission to the surgical unit and appendectomy is the most common emergency procedure performed worldwide. The accuracy of diagnosis is not straightforward at all times. A lower negative appendectomy rate (NAR) is regarded internationally as a quality indicator of the treating center. Objective: To determine the diagnostic accuracy of appendicitis by clinical, radiological and histopathological fndings. Design: A Retrospective Review. Setting: King Hamad University Hospital, Bahrain. Method: Patients who had appendectomy were included in the study. Data were documented between January 2013 and December 2014. All patients above 14 years of age were included. Incidental appendectomy and appendicitis during pregnancy were excluded from the study. Result: The medical records of 286 patients who underwent appendectomy were reviewed; 187 (65.4%) were males. The mean age was 29.3 years. The negative appendectomy rate (appendix is normal on histopathology) was 29 (10.1 %) while another pathology other than appendicitis was found in one (0.349%). Twenty-nine patients had a normal appendix, 20 were females. The total perforation rate was 28 (10%). Complications were encountered in 2 (0.69%) patients. Ultrasound was used in 86 (30.1%) patients and conventional tomography used in 67 (23.43%) cases. The overall accuracy of both clinical and radiological diagnosis was 89.16%. The mean age was 29.3 years. Conclusion: The diagnostic accuracy, in our study, was 89.16%. Clinical diagnosis and radiological imaging, especially in females, could decrease the NAR to an acceptable rate. Bahrain Med Bull 2016; 38(4): 219 - 222 complaint of other pathologies which mimic appendicitis, especially among females 2 . Atypical histories lack this typical progression and may include pain in the right-lower quadrant as an initial symptom, which could lead to a delayed diagnosis or even a missed diagnosis 3 . Ultrasound (US) and CT scan have been widely used as an adjunct to the clinical examination in atypical and complicated cases, especially in females 4 . The use of US is undermined by * Senior Registrar Department of General Surgery ** Consultant Department of Pathology King Hamad University Hospital *** Professor of Clinical Surgery The Royal College of Surgeons in Ireland, Medical University Bahrain **** Registrar Department of General Surgery ***** Chief of Medical Staff, Consultant Pediatric Surgeon Department of Surgery Professor and Head of Surgery Department, RCSI-MUB ****** Senior House Offcer Department of Pathology ******* Chief of Pathology, Blood Bank and Laboratory Medicine Consultant and Associate Professor of Pathology Director of Diagnostic Departments, Rehabilitation and Allied Health Services King Hamad University Hospital Kingdom of Bahrain E-mail: mohammed.zurub@khuh.org.bh