Acute appendicitis in women of childbearing age

To find a way to decrease the incidence of laparotomies negative for appendicitis, we studied 108 female patients between the ages of 15 and 45 years who had undergone appendectomy with the diagnosis of acute appendicitis. Of these 108 patients, 56 had acute appendicitis and 52 had normal appendixes. The patients between the ages of 15 and 25 years had a 59% incidence of negative laparotomies, in comparison with those patients between 36 and 45 years old, who had an incidence of 22%. In patients with normal appendixes, 18 had no intra-abdominal pathologic findings. Twenty had pelvic inflammatory disease, and nine had ovarian abnormalities. There were no differences in the clinical symptoms, vital signs, roentgenographic findings, or other laboratory studies between the two groups. There were no in-hospital perforated appendixes in the patients who were operated on within 48 hours of admission. To decrease the incidence of negative appendectomies, we recommend in-house observation and simultaneous examination of the patient by the surgeon and a gynecologist.