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

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 (χ2) 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.