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[Chronic appendicitis as an independent clinical entity]
T Mussack1, S Schmidbauer, A Nerlich
1Chirurgische Klinik und Poliklinik-Innenstadt, Klinikum der Universität München, Nussbaumstrasse 20, 80336 München. tmussack@helios.med.uni-muenchen.de
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|September 24, 2002
Summary
Chronic appendicitis, characterized by persistent pain, is often diagnosed post-surgery. This study found that a preoperative pain duration exceeding 7 days strongly suggests chronic appendicitis, with most patients experiencing long-term relief after appendectomy.
Area of Science:
- Gastroenterology
- Surgical Pathology
Context:
- Chronic appendicitis lacks definitive diagnostic criteria, often leading to delayed diagnosis.
- Persistent or recurrent right lower quadrant pain can indicate chronic appendicitis.
Purpose:
- To determine the incidence of chronic appendicitis.
- To compare clinical and histological findings.
- To evaluate long-term outcomes after appendectomy.
Summary:
- Appendectomy was performed on 322 patients; 112 presented with non-acute symptoms.
- Histological analysis revealed chronic inflammation or fibrosis in 92.6% of these cases.
- A preoperative pain duration of over 7 days predicted non-acute appendicitis with high specificity (89.9%).
Impact:
- Histological confirmation of chronic appendicitis was achieved in most patients with prolonged pain.
- Over 93% of patients reported long-term asymptomatic status post-appendectomy.
- Recommends considering chronic appendicitis for persistent pain >7 days, suggesting elective appendectomy.