Jones B A, Demetriades D, Segal I, Burkitt D P
Ann Surg. 1985 Jul;202(1):80-2. doi: 10.1097/00000658-198507000-00013.
Appendicitis is more common in developed than in developing societies and appendiceal fecaliths are thought to have an etiologic role in the disease. The geographic distribution of appendiceal fecaliths was investigated by systematic, intraoperative palpation of the appendix in patients in Toronto, Canada and Johannesburg, South Africa. The incidences of fecaliths found on pathologic sectioning of the appendix in appendicitis patients in both societies were compared. In the Canadian population, the prevalence of fecaliths in patients whose appendices were palpated incidentally was 32% versus 52% for those with appendicitis (p less than 0.01). In the African population, the prevalence of fecaliths in patients whose appendices were palpated incidentally was four per cent versus 23% for those with appendicitis (p = 0.04). The difference in prevalence of incidental appendiceal fecaliths in the two populations was statistically significant (p less than 0.005). The prevalence of fecaliths is higher in developed countries, such as Canada, than in developing countries, such as Africa, and is also higher in patients with than in those without appendicitis. These data support the theory that the low-fiber diets consumed in developed countries lead to fecalith formation, which then predisposes to appendicitis.
阑尾炎在发达国家比在发展中国家更为常见，阑尾粪石被认为在该病的病因中起作用。通过对加拿大多伦多和南非约翰内斯堡患者的阑尾进行系统的术中触诊，研究了阑尾粪石的地理分布。比较了两个地区阑尾炎患者阑尾病理切片中发现粪石的发生率。在加拿大人群中，偶然触诊阑尾的患者中粪石的患病率为32%，而阑尾炎患者为52%（p<0.01）。在非洲人群中，偶然触诊阑尾的患者中粪石的患病率为4%，而阑尾炎患者为23%（p = 0.04）。两个人群中偶然阑尾粪石患病率的差异具有统计学意义（p<0.005）。粪石的患病率在加拿大等发达国家高于非洲等发展中国家，且在患有阑尾炎的患者中也高于未患阑尾炎的患者。这些数据支持了这样一种理论，即发达国家食用的低纤维饮食会导致粪石形成，进而易引发阑尾炎。
