Leardi S, Delmonaco S, Ventura T, Chiominto A, De Rubeis G, Simi M
Dipartimento di Discipline Chirurgiche, Università degli Studi, L'Aquila.
Minerva Chir. 2000 Jan-Feb;55(1-2):39-44.
Chronic appendicitis may be the cause of recurrent abdominal pain. This hypothesis is the subject of controversy. The aim is to clarify the possible existence of a chronic inflammation of the appendix by a clinical and histopathologic study.
The case history and the preoperative symptoms and serum findings of 269 patients with appendectomy have been studied. All the appendices have been histologically examined. Chronic appendicitis was diagnosed when at least two typical histological factors of chronic inflammation were present. The histological findings of the appendices have been correlated with preoperative clinical and serum findings of the patients. 14-46 months after the appendectomy, the patients have been examined.
Histological examination revealed 187 cases (69.5%) with acute appendicitis, 44 cases (16.3%) with non disease of appendix and 38 cases (14.2%) with chronic appendicitis. Recurrent abdominal pain and normal leukocyte count were closely correlated (chi 2 = 18.3, p < 0.001; chi 2 = 21.3, p < 0.001 respectively) with diagnosis of chronic appendicitis. 81.8% of 33 patients with chronic appendicitis who underwent follow-up had relief of all the symptoms after appendectomy.
Therefore, the study seems to confirm the existence of a clinico-pathological condition that can be defined as chronic appendicitis, resolvable with appendectomy.
慢性阑尾炎可能是反复腹痛的病因。这一假说存在争议。目的是通过临床和组织病理学研究阐明阑尾慢性炎症可能的存在情况。
对269例行阑尾切除术患者的病史、术前症状及血清学检查结果进行了研究。所有阑尾均进行了组织学检查。当存在至少两种慢性炎症典型组织学因素时诊断为慢性阑尾炎。将阑尾的组织学检查结果与患者术前临床及血清学检查结果进行了关联分析。阑尾切除术后14 - 46个月对患者进行了检查。
组织学检查显示187例（69.5%）为急性阑尾炎，44例（16.3%）阑尾无病变，38例（14.2%）为慢性阑尾炎。反复腹痛及白细胞计数正常与慢性阑尾炎诊断密切相关（分别为χ² = 18.3，p < 0.001；χ² = 21.3，p < 0.001）。33例接受随访的慢性阑尾炎患者中81.8%在阑尾切除术后所有症状缓解。
因此，该研究似乎证实了一种可定义为慢性阑尾炎的临床病理状况的存在，阑尾切除术可解决该问题。
