Sequelae of appendectomy, with special reference to intra-abdominal adhesions, chronic abdominal pain, and infertility.

We analyzed the case histories and operation protocols of 2,465 female patients who had undergone pelviscopy for various reasons at the University Clinic of Obstetrics and Gynecology, Kiel, in the years 1978-1982. 1,743 patients (71%) had reported a previous appendectomy, of whom 965 had had no other intra-abdominal operation. 657 of the latter (68.1%) presented adhesions; these were located in the right middle abdomen in 36.4% of the cases. In comparison to a collective of 308 patients without adhesions after appendectomy, the existence of chronic lower abdominal pain was independent of the presence of adhesions (30-31% in both groups). In 55% of the patients with adhesions who were infertile after appendectomy, periovarian and peritubal adhesions were registered. In order to avoid unnecessary appendectomy or other laparotomies with later formation of adhesions, the use of laparoscopy is recommended in all questionable cases.