Peritoneoscopy for the diagnosis of acute appendicitis in females of reproductive age.

The diagnosis of acute appendicitis in women of reproductive age can be a difficult clinical problem. A retrospective audit found our incidence of normal appendix removal in this patient population to be 42%. This study was undertaken to determine if the selective use of peritoneoscopy would improve the accuracy of diagnosis and thereby reduce the need for celiotomy in these patients. Peritoneoscopy was performed on 21 patients, and acute appendicitis was confirmed in 12 cases. Tubo-ovarian pathology was found in 5 patients, no pathology was found in 4 patients, and an unnecessary celiotomy was avoided in 8 patients. The incidence of normal appendix removal was reduced to 15%. There were no serious complications associated with peritoneoscopy. Diagnostic peritoneoscopy should be liberally employed in women of reproductive age with suspected appendicitis.