Relationship between the removal of the nonacute appendix and the menstrual cycle

The significantly higher incidence of removal of a normal appendix in females in the second, third and fourth decades of life for suspected acute appendicitis lead to a study of the frequency of appendicectomy and the peroperative findings at the time of surgery in patients in different phases of the menstrual cycle. The results showed that the frequency of acute appendicitis in the luteal phase was more than twice the frequency of the disease in the remaining half of the menstrual cycle. Further, there was a significantly higher proportion of gangrenous, perforated and normal appendices removed from patients in the menstrual and follicular phases of the menstrual cycle. The diseases mimicking acute appendicitis are tabulated. From these results it can be concluded that the female sex hormones might play an important aetiological role in the development of acute appendicitis or influence the inflammatory process in the appendix.