Steinbrugger B, Kurz R, Pfeiffer K P, Brandesky G, Hartl H, Henkel H, Menardi G, Miholic J, Preier L
Chirurg. 1982 Jul;53(7):431-5.
In this multicentric study the anamnestic data and parents questionaires of 2-29 children were evaluated, whose appendix vermiformis at the time of operation showed no signs of inflammation. 31,1% macroscopically showed cicatrisation or fasciation, in 13,7% other enteral or gynaecological (1%) findings were present. In 1194 of the cases of patho-histological examination of the appendix had been made of which 36.4% were negative, 37.7% showed cicatrisation, 15,0% oxyuriasis and 10,4% coproliths. In the discussion of the significance of the chronically altered non-inflamed appendix we compared patients with and without macroscopical or microscopical alterations. We came to the conclusion that the probability-index as to sex, duration of symptoms, complexity of symptoms, incidence of postoperative well-being, proved the chronically altered appendix not to be an illness per se, but the result of spontaneously arrested inflammation. Since the rate of children admitted with a perforated appendix is high (15-20%) in comparison with the rate of complications after removal of non-inflamed appendices (2,9%), we believe that according to the diagnostical problems the principle can be maintained: in dubio pro operatione.
在这项多中心研究中，对2至29岁儿童的既往病史数据和家长调查问卷进行了评估，这些儿童在手术时阑尾未显示炎症迹象。31.1%的阑尾在宏观上显示有瘢痕形成或粘连，13.7%有其他肠道或妇科（1%）的发现。对1194例阑尾进行了病理组织学检查，其中36.4%为阴性，37.7%显示瘢痕形成，15.0%有蛲虫病，10.4%有粪石。在讨论慢性改变的非炎症性阑尾的意义时，我们比较了有和没有宏观或微观改变的患者。我们得出的结论是，关于性别、症状持续时间、症状复杂性、术后良好状态发生率的概率指数证明，慢性改变的阑尾本身不是一种疾病，而是自发停止炎症的结果。由于与切除非炎症性阑尾后的并发症发生率（2.9%）相比，阑尾穿孔患儿的入院率较高（15 - 20%），我们认为根据诊断问题，可以坚持这一原则：存疑时应手术。
