The grumbling appendix in urban Zimbabwe--what are we treating?

The concept of chronic appendicitis has not been accepted by pathologists. However, quite a number of patients with chronic Right Iliac Fosa (RIF) pain are subjected to appendicectomy. Most of them are found to have fibrosed appendices indicating previous inflammation. A number are found normal. A number of urban people with Right Iliac Fosa (RIF) pain have established parasitic conditions which can be found if they are thoroughly investigated. Some of these may be responsible for the grumbling appendix syndrome.