Sequelae of Appendectomy, with Special Reference to Intra-Abdominal Adhesions, Chronic Abdominal Pain, and Infertility

Abstract

We analyzed the case histories and operation protocols of 2,465 female patients who had undergone pelviscopy for various reasons at the University Clinic of Obstetrics and Gynecology, Kiel, in the years 1978–1982. 1,743 patients (71%) had reported a previous appendectomy, of whom 965 had had no other intra-abdominal operation. 657 of the latter (68.1 %) presented adhesions; these were located in the right middle abdomen in 36.4% of the cases. In comparison to a collective of 308 patients without adhesions after appendectomy, the existence of chronic lower abdominal pain was independent of the presence of adhesions (30–31 % in both groups). In 55% of the patients with adhesions who were infertile after appendectomy, periovarian and peritubal adhesions were registered. In order to avoid unnecessary appendectomy or other laparotomies with later formation of adhesions, the use of laparoscopy is recommended in all questionable cases.

Comparison of Adhesion Formation in Open and Laparoscopic Surgery

“…Partial or complete mechanical bowel obstruction, if it occurs as an early or late complication of abdominal surgery is highly suspicious of intra-abdominal adhesions [12, 13]. Postoperative adhesions and fibrous scars due to endometriosis and acute appendicitis are common causes of secondary infertility in young females of child-bearing age [14]. However, the clinical relevance of these adhesions may often only be assessed by a diagnostic laparoscopy [7].…”

Treatment of Perforated Appendicitis: An Analysis of 362 Patients Treated during 8 Years

“…In the non-perforated group the complication rate is about 10% [3], but in the perforated group the incidence has been reported to be as high as 40% [4]. Some reports indicate a higher risk for infertility in females [5, 6]and also an increased risk for intestinal obstruction of about 2–5% [7, 8]. …”

Inflammatory Bowel Disease and Pregnancy: A Review

“…These side effects are reversible within 3 months of stoprates as inferred from studies examining the sequelae of appendectomy [8,9]. Though no studies have specifically ping therapy, and can be circumvented entirely with the utilization of 5-aminosalicyclic acid products [14].…”