Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Chronic appendicitis is not generally accepted as an independent clinical entity. The diagnosis is often made only after histological analysis when the patient has undergone appendectomy in a case of persistent or recurrent pain. The objectives of this prospective study were to analyse the incidence of chronic appendicitis among our patients, to compare demographic and clinical data with histological results and to evaluate long-term follow-up after appendectomy. ⋯ Three quarter of all patients with pain in the right lower quadrant but no significant signs of inflammation showed the histological criteria for chronic appendicitis. However, histology revealed signs of an acute inflammation in 25% of patients. An optimal cut-off value of 7 days preoperative period of pain was able to suggest a histologically non-acute appendicitis with a high specificity and a high positive predictive value. More than 93% of these patients were asymptomatic in their long-term follow-up. Chronic appendicitis must be assumed in cases of recurrent or persistent pain longer than 7 days and an elective appendectomy has to be recommended.