Acute appendicitis: Leaving normal looking appendices

doi:10.1136/bmj.333.7569.652-a

BMJ 2006;333:652 (23 September), doi:10.1136/bmj.333.7569.652-a

Letter

Acute appendicitis

Leaving normal looking appendices

The first 150 words of the full text of this article appear below.

EDITOR—In their clinical review of acute appendicitisHumes and Simpson point out that complications can occur afterremoval of a normal appendix.¹ To decrease the rate of negativeappendicectomies, the use of diagnostic laparoscopy followedby either laparoscopic or open appendicectomy may be beneficial.Diagnostic laparoscopy allows the doctor to leave a normal lookingappendix, identify alternative pathologies, or accurately sitea small incision for open appendicectomy.

We audited 187 diagnostic laparoscopies for suspected acuteappendicitis over two years in a district general hospital wherediagnostic laparoscopy is routine and found 141 diagnostic laparoscopies(75%) proceeded to laparoscopic appendicectomy while the remaining46 patients (25%) had a macroscopically normal appendix, andno appendicectomy was performed. Hospital stay and complicationsfollowing laparoscopic appendicectomy were favourable comparedwith open appendicectomy, and outcomes were similar regardlessof grade of operating surgeon. Controversy persists over thesafety of leaving a "normal" looking . . . [Full text of this article]