[Laparoscopy useful in the diagnosis and surgery of acute appendicitis]

The value of diagnostic laparoscopy was evaluated in 74 patients who had clinical signs of acute appendicitis. The average age was 27 years (5-67). The laparoscopically determined degree of inflammation was compared with the results of histologic examination, and the results of laparoscopic appendectomy were evaluated. In 6 patients laparoscopic appendectomy was not performed, because of infiltrative disease (twice), twisted ovary, ovulatory bleeding, enteritis and partially incarcerated inguinal hernia. In 2 patients suffering of acute appendicitis conversion to laparotomy was necessary because of obscured anatomy. On 57 out of 68 patients who underwent appendectomy, the laparoscopic findings were in accordance with histologic examination; i.e. 54 times acute appendicitis and 3 times appendix sana. In 7 patients the appendix was classified as inflamed during laparoscopy, histological examination revealing lymphoid hyperplasia or a subacute inflammation. In 4 patients with a laparoscopically normal appendix, inflammation was seen histologically. The average operation time was 29 minutes and the average postoperative hospital stay was 4 days. Three complications occurred: an inflammatory mass developed in 2 patients post-operatively and I patient had a hematoma in the trocar puncture site and a wound abscess developed. Laparoscopy is an aid in diagnosing appendicitis, and may prevent unnecessary appendectomy. If inflammation is established appendectomy can be performed safely and effectively.