Clinical Existence of Obstructive Appendicopathy

Abstract

What are the factors that clinically mimick appendicitis in negative appendectomy patients? A prospective study comparing incidentally histologically normal appendices (n = 42) to negative appendectomy (n = 107) has been performed with regard to the local conditions of the appendix. Sharp angulation, fecalith and lymphoid hyperplasia and the mean luminal resistance of the appendix to water perfusion were significantly higher in the negative appendectomy group (p level 0.01, 0.00, 0.02 and 0.00, respectively). The mean luminal resistance of the appendix to water perfusion was significantly higher in cases of fecalith than in cases where this was absent. This was not found for sharp angulation and lymphoid hyperplasia, but both were significantly related to the existence of fecalith. It is clear that obstruction, especially fecalith, was responsible for the clinical mimicking of appendicitis. Using the term ‘obstructive appendicopathy’ in the normal appendix with obstructive factors is quite relevant.