Chronic Right Iliac Fossa Pain Relieved by Appendicectomy? A Fact or Myth?
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 11
Abstract
Background: Although chronic right iliac fossa (RIF) abdominal pain is a common clinical condition, the diagnosis and treatment are still under debate. In spite of literature evidence, the existence of recurrent or chronic appendicitis continues to be debated especially, whether chronic appendicitis really exists and whether it can explain the persistent or chronic RIF abdominal pain. Aim: The aim of the study was to study the undiagnosed chronic RIF pain, in which the ultrasonogram and computerized tomography scan showed no definite findings and whether those subset of patients will be relieved after elective laparoscopic appendicectomy. Methods: A total of 60 patients, 12–60 years of age, with undiagnosed chronic RIF abdominal pain underwent diagnostic laparoscopy and appendicectomy. 10 patients were excluded from the final analysis because of the presence of an obvious associated non-appendicular pathology also. Patients were followed up for 6 months at regular intervals (1, 3, and 6 months) and were assessed for pain relief. The association between clinical outcome and the histopathological outcome was studied. Results: The histopathological examination of appendices revealed appendicitis in all patients. Intra-operative evidences of chronic appendicitis were seen in 42 (84%) patients. 47 (94%) patients were completely pain-free on follow up, and only 3 (6%) patients had persistence of pain. Conclusions: Patients with chronic RIF abdominal pain (without an obvious diagnosis on preoperative evaluation) can safely undergo exploratory laparoscopy and appendicectomy. Chronic appendicitis is a diagnosis of exclusion with intraoperative and histopathological evidence. Patients with RIF abdominal pain and RIF tenderness with otherwise normal findings on sonology are having chronic or recurrent inflammation of the vermiform appendix and are fully curable by laparoscopic appendicectomy.
Authors and Affiliations
A Ramesh, G Rajendran, D Aravind, Heber Anandan
Keywords
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