EVALUATION OF CHRONIC INFLAMMATION IN APPENDECTOMY SPECIMENS

Acute inflammation is the most common pathologic change in appendix and it has a well-recognized clinical presentation. However, in some patients, definite diagnosis and treatment may be delayed due to the atypical clinical course of the disease. Patients may present with chronic pain alone or chronic with acute attack of abdominal pain in right lower quadrant with or without other gastrointestinal symptoms. Chronic appendicitis may be a cause of chronic right lower quadrant (RLQ) abdominal pain and its prevalence has been a debated between surgeons and pathologists. This study was retrospectively performed on 1152 appendix specimens obtained following appendectomy due to acute appendicitis, in Ahwaz Imam Khomeini Hospital between 1998-2000. We evaluated the presence of pathological changes associated with chronic inflammation in the samples. We found that acute appendicitis was more prevalent in men (754 cases and 65.5%) than in women (398 cases and 34.5%). Pathologically 162 (14%) of cases had normal appendix, 30 (2.6%) were in early phase, 844 (73.3%) were in suppurative phase of appendicitis. On the other hand, 67 (5.8%), 32(2.8%), 17(1.5%) of cases were in gangrenous, perforation and chronic phases of appendicitis respectively.We concluded that although the chronic inflammation is less common pathologic change of appendix but this may explain some cases of chronic abdominal pain in right lower quadrant.