[Complications in patients who underwent appendectomy for mistakenly diagnosed acute appendicitis]

A retrospective investigation was undertaken concerning 552 patients who were submitted to appendectomy on account of suspected acute appendicitis during the period January 1 1983-December 31 1987. The diagnostic certainty was found to be 69%. A total of 14.3% (79/552) developed postoperative complications, including 20 patients in whom normal appendices were removed. Some of the complications were possibly attributable to the cause of the symptoms of acute appendicitis but this was not possible to determine by review of the case records. No differences were found in the frequencies of complications in whom normal appendices were removed as compared with those in whom inflamed appendices were removed. The frequency of perforation was 17.2% (95/552) which is in agreement with the findings in previous investigations. It may thus be concluded that the incidence of complications associated with removal of a normal appendix is no greater than after removal of an inflamed appendix. Removal of a normal appendix is, however, not a harmless procedure. The incidence of "negative appendectomy" must be reduced by meticulous observation and repeated reassessment of the patient and employment of other diagnostic aids e.g. ultrasonic scanning or laparoscopy in order to confirm or refute the diagnosis prior to possible operation.