Abstract

SANCHEZ- ARIAS, Mario. Apendicitis crónica, ¿existe o no?. Acta méd. costarric [online]. 2007, vol.49, n.1, pp.47-50. ISSN 0001-6002.

For many years it has been taught in medical schools and surgery textbooks that appendicitis is exclusively an acute process. Although not all the cases of right lower quadrant pain are so clear to diagnose acute appendicitis, in a certain percentage of those cases we proceded with appendectomy and the histopathologycal findings showed chronic inflammation. In the present communication, I present a retrospective analysis of 6 cases. The first 5 were operated with a preoperative diagnosis of acute appendicitis, and the last one with a preoperative diagnosis of chronic appendicitis. These cases were collected over 8 years at the former Hospital Clínica Católica. The frecuency was 5% of the total cases of appendectomy performed by the author, 67% were males and 33% were females, with an average preoperative course of 64 days. Right lower quadrant pain was present in 83% and all the cases had a positive biopsy for chronic inflammation and fibrosis. One 100% were asymptomatic after surgery. Special attention should be paid to case number 6 who had 3 consulations for recurrent right lower pain during the last year an ultra sound was consistent with chronic appendicitis. I made the diagnosis pre-operatively and operated on him electively. The biopsy was also positive for chronic inflammation. Because of that I concluded that chronic appendicitis is a real entity and recommend surgery (open or laparoscopic) in those patients with chronic or recurrent pain in the right lower abdominal quadrant

Keywords : Acute abdomen; apendicitis; chronic abdominal pain.

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