[Histopathological findings in incidental appendectomies during gynecologic laparotomies and their significance for the patient].

Incidental appendectomy is a more and more frequent part of gynaecological laparotomies. Doubts about the increased post-operative morbidity and mortality have been shown to be unfounded in numerous series. Opinions on contra-indications to incidental appendectomy are divided. German language authors do not do incidental appendectomies with Caesarean Sections, operations for Ectopic pregnancies, Tubo-Ovarian Abscess and Inoperable Carcinoma. In the English speaking literature an increasing number of authors show that even under these circumstances the appendectomy is without danger. Incidental appendectomy is indicated because of the high incidence of abnormal findings at microscopic examination and because the appendix may be a potential hazard for some groups of patients especially pregnant women and elderly women. An increased mortality can be attributed to the potential site of the disease in the appendix. The possible long term complications of incidental appendectomy by adhesions or bowel obstruction are lower than the potential risk of morbidity or mortality with the appendix in situ. In our series microscopic examination of one hundred and thirteen incidentally removed appendices showed abnormal findings in 82.9% of the cases. The appendices were removed in a series of 267 gynaecological laparotomies. In 17% of the cases the findings were important for the patient. An increased post-operative morbidity or mortality was not found in our series. The hospital stay was not prolonged over that of a comparitive group. The risk of a left behind appendix was calculated from a study of the literature both as to morbidity and mortality and compared to the possible short term and long term morbidity from an incidental appendectomy.