Barber M D, McLaren J, Rainey J B
Department of Surgery, St John's Hospital at Howden, Livingston, UK.
Br J Surg. 1997 Jan;84(1):110-2.
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.
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.
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).
Recurrent appendicitis exists and affects at least 6.5 per cent of those who ultimately have an inflamed appendix removed.
阑尾炎症不经手术干预而自行消退的情况长期以来一直存在争议。因此，开展本研究以确定复发性阑尾炎的存在情况及发病率。
拥有大量腹痛患者数据库，使得对1982年1月至1991年12月间在一家苏格兰地区综合医院接受阑尾切除的1084例阑尾发炎患者的病历进行回顾性研究成为可能。在此期间连续60例切除正常阑尾的患者也纳入研究。
71例患者（6.5%）因与阑尾炎相符的症状和体征89次前往急诊部就诊，这些症状和体征在切除发炎阑尾就诊前3周至12年间自行消退。症状消退的患者、阑尾正常的患者和阑尾发炎的患者在临床体征和症状（使用阿尔瓦拉多评分系统）方面存在显著差异。切除正常阑尾的患者中女性比例高于症状消退的患者（分别为67%和42%，P<0.01）。
复发性阑尾炎确实存在，且至少影响最终切除发炎阑尾患者中的6.5%。
