Recurrent appendicitis.

BACKGROUND

The existence of appendiceal inflammation which resolves spontaneously without surgical intervention has long been controversial. This study was undertaken, therefore, to determine the existence and incidence of recurrent appendicitis.

METHODS

The existence of a large database of patients with abdominal pain enabled a retrospective study of the casenotes of the 1084 patients who had an inflammed appendix removed between January 1982 and December 1991 in a Scottish District General Hospital. Sixty consecutive patients who had a normal appendix removed during this period were also studied.

RESULTS

Seventy-one patients (6.5 per cent) attended the accident and emergency department 89 times with symptoms and signs compatible with appendicitis which resolved spontaneously between 3 weeks and 12 years before an attendance during which an inflamed appendix was removed. There were significant differences in clinical signs and symptoms (using the Alvarado scoring system) between patients whose symptoms resolved, those with a normal and those with an inflamed appendix. Those who had a normal appendix removed were more likely to be female than those with resolving symptoms (67 versus 42 per cent, P < 0.01).

CONCLUSION

Recurrent appendicitis exists and affects at least 6.5 per cent of those who ultimately have an inflamed appendix removed.