[Epidemiological aspects of chronic appendicitis]

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Right iliac pain is a common symptom with various differential diagnoses.
• Acute appendicitis is a frequent surgical emergency, but non-specific presentations can complicate diagnosis.
• Chronic appendicitis is an under-recognized entity that may contribute to persistent or recurrent right iliac pain.

Purpose of the Study:

• To determine the frequency of acute surgical disease absence in patients presenting with right iliac pain.
• To establish the incidence of chronic appendicitis based on morphological examination of surgically resected appendices.
• To investigate clinical and morphological correlations between chronic appendiceal changes and right iliac pain.

Main Methods:

• Analysis of 915 diagnostic laparoscopies performed for suspected acute appendicitis.
• Morphological investigation of 321 appendices resected for acute appendicitis to identify chronic changes.
• Review of literature and personal experience to assess the recurrence rate of secondary chronic appendicitis.

Main Results:

• The study quantified the frequency of negative appendectomies (absence of acute surgical disease) in cases of suspected appendicitis.
• Morphological analysis revealed a specific frequency for chronic appendicitis among resected appendices.
• Correlations were explored between non-inflammatory appendiceal changes and the symptom of right iliac pain.

Conclusions:

• The findings provide data on the prevalence of chronic appendicitis, suggesting it may be less common than often presumed in the context of right iliac pain.
• Understanding the frequency of chronic appendicitis can refine diagnostic approaches and surgical decision-making for patients with persistent right iliac pain.
• Further research into the clinical-pathological correlations of chronic appendiceal changes is warranted.