Consequences of removal of a "normal" appendix

Area of Science:

• Surgery
• Gastroenterology
• Clinical Medicine

Background:

• Appendicitis is a common surgical emergency.
• Accurate pre-operative diagnosis can be challenging.
• Unnecessary appendicectomies (removing non-inflamed appendices) occur.

Purpose of the Study:

• To review outcomes of appendicectomy.
• To assess the incidence of non-inflamed appendices removed.
• To evaluate complications and mortality associated with appendicitis and appendicectomy.

Main Methods:

• Retrospective review of 500 consecutive appendicectomy cases.
• Analysis of operative findings, including appendix inflammation status.
• Assessment of pre-operative diagnostic accuracy and post-operative complications.

Main Results:

• 29.6% of removed appendices were non-inflamed, with higher incidence in females.
• Perforated appendicitis rate was 6.5% with no associated deaths.
• Post-operative complications (mainly infections) were higher in appendicitis cases (19.3%) than non-inflamed cases (6.7%).

Conclusions:

• Clinical evaluation alone is insufficient for definitive pre-operative diagnosis of appendicitis.
• Appendicectomy is a safe management option for suspected appendicitis with diagnostic uncertainty.
• Early surgical intervention offers the best outcomes in suspected appendicitis.