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The menstrual cycle and acute appendicitis

S Eldar1, D Faraggi, J Abrahamson

  • 1Department of Surgery, Bnei Zion Medical Center, Haifa, Israel.

The European Journal of Surgery = Acta Chirurgica
|December 1, 1995
PubMed
Summary
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Acute appendicitis incidence is not affected by the menstrual cycle. However, operations for uninflamed appendixes may be more common during menstruation, suggesting a functional disorder mimicking appendicitis.

Area of Science:

  • Gynecology
  • Gastroenterology
  • Surgical Pathology

Background:

  • The menstrual cycle is a complex hormonal process.
  • Acute appendicitis is a common surgical emergency.
  • Understanding potential influences on appendicitis presentation is clinically relevant.

Purpose of the Study:

  • To investigate if the menstrual cycle influences the occurrence and clinical features of acute appendicitis.
  • To analyze appendicitis presentation across different menstrual phases.

Main Methods:

  • Retrospective study conducted at a university hospital.
  • Inclusion of 144 women of childbearing age operated on for suspected acute appendicitis.
  • Subdivision of patients based on menstrual phase at presentation, analyzing diagnoses, clinical presentation, and laboratory data.

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Main Results:

  • No significant differences in the incidence of acute, gangrenous, or perforated appendicitis were observed across menstrual phases.
  • A normal appendix was found more frequently during menstruation (p = 0.04).
  • Clinical presentation and laboratory findings were consistent across phases, except for "classic shifting pain," which was more common in the luteal phase.

Conclusions:

  • Acute appendicitis incidence appears random throughout the menstrual cycle.
  • The rate of operations for uninflamed appendixes may increase during menstruation.
  • Increased negative laparotomies during menstruation suggest a functional disorder mimicking appendicitis symptoms.