Is H.Pylori Incriminated as Etiology for Acute Appendicitis or not?

Abstract

Background: Appendicitis is the most common abdominal surgical emergency. There is an approximately 6% to 8% lifetime risk of appendicitis. Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. H.pylori colonizes mainly stomach and duodenum but also, reported in other sites. Objective: This study was proposed for finding out if there is a relation between H.pylori infection and acute appenendicitis. Methods: The current study was prospectively conducted at Surgical Department of Benha University and Assiut General Hospital. The study conducted two hundreds patients were clinically, laboratory and radiologically diagnosed to have acute appendicitis. Results: Many authors studied the relationship between appendicitis and H.pylori but still this relation is controversial. This study was done to study if there is a relation between H.pylori infection and acute appendicitis. Two hundred patients with confirmed acute appendicitis were enrolled. Diagnosis of acute appendicitis was done based on clinical, laboratory and radiological data. Majority (63%) of those patients were males with mean age of all patients were 24.12 ± 9.50 years with range between 8 and 62 years. based on blood tests, 143 (71.5%) patients were seropositive while only 57 (28.5%) patients were seronegative. Also, H.pylori antigen in stool was positive in 88 (44%) patients and histopathology of the specimen revealed that only 10 (5%) patients were positive to H.pylori. Also, in the current study; 48.3% of those with seropositive H.pylori had suppurative appendicitis while 59.6% of those with seronegative H.pylori had catarrhal appendicitis. Based on the current we found that patients with seropositive H.pylori had more severe form of acute appendicitis. Till now, there is controversy about role of H.pylori in the pathogenesis of acute appendicitis. Based on the current study, it’s recommended to perform such studies prospectively in multiple centers with large sample size. Conclusion: It seems that there is controversy about role of H.pylori in the pathogenesis of acute appendicitis. However seropositive patients are more likely to have perforated and gangrenous appendicitis and have more post-operative SSI.