BMJ  2006;333:653 (23 September), doi:10.1136/bmj.333.7569.653

Letter

Acute appendicitis

Acute appendicitis or acute appendicectomy?

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

EDITOR—Over 40 years ago, I studied the clinical pathology of the appendix and the epidemiology of appendicectomy. I would like to comment on four complementary issues.1 Firstly, around 1960 the 4/1000 death rate ranged from 1/2600 for uncomplicated appendicitis in young adults, to 1/9 for patients older than 50 with a perforated appendix. Death rates for male patients were double those for female patients. Deaths from a normal appendicectomy were 1/5000 in young adults.2 In my own study of 1412 appendicectomies, surgeons differed over whether to risk removing normal appendixes or leave abnormal ones in, and deaths from higher and lower operative approaches balanced almost exactly. However, morbidity from the more conservative approach was higher due to more readmissions, and more patients continued to complain of pain in the right iliac fossa.3

Secondly, 37 of 45 patients with recurrent or chronic appendicitis had iron deposits in their appendixes, . . . [Full text of this article]

John G R Howie, emeritus professor of general practice

University of Edinburgh, Edinburgh EH8 9DX john.howie00@btinternet.com


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Relevant Article

Acute appendicitis
D J Humes and J Simpson
BMJ 2006 333: 530-534. [Extract] [Full Text] [PDF]

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