Laparoscopic appendectomy for chronic right lower quadrant abdominal pain

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Chronic right lower quadrant abdominal pain (RLQAP) can be attributed to the appendix, even without clear imaging abnormalities.
• This condition is often termed chronic appendicitis or neurogenic appendicopathy.

Purpose of the Study:

• To evaluate the efficacy of elective appendectomy in patients with chronic RLQAP.
• To assess postoperative pain reduction and symptom resolution.

Main Methods:

• Prospective analysis of patients undergoing elective appendectomy for chronic RLQAP between 2006 and 2013.
• Inclusion criteria: chronic RLQAP without imaging abnormalities; exclusion criteria: prior complicated appendicitis or imaging findings.
• Primary outcome: postoperative pain scores using the Visual Analogue Scale (VAS).

Main Results:

• Ten patients met the inclusion criteria, with an average preoperative VAS of 8.6.
• Histopathology revealed subtle abnormalities in 80% of cases, suggesting prior inflammation.
• Postoperatively, average VAS dropped to 1.0 at 3 weeks and remained at 1.0 after a median of 33 months, with no complications.

Conclusions:

• Appendectomy significantly reduced pain in patients with chronic RLQAP.
• Seven out of ten patients achieved complete pain relief, indicating appendectomy's value for this condition.