Intestinal obstruction after appendectomy.
BACKGROUND
The frequency of intestinal obstruction varies in the literature (0.2-10.7%) and requires evaluation in a proper design.


METHODS
From 1978 to 1985, 1951 patients underwent appendectomy; 58 patients were excluded because of appendectomy per occasionem, 156 because of previous laparotomy, and 190 because of simultaneous major surgery. Three foreigners were lost to follow-up. The cohort was linked to the Danish National Inpatient Register for identification of cases, defined by intestinal obstruction requiring surgical intervention.


RESULTS
The follow-up period was long (median, 3563 days; range, 2-5113). Twenty-one patients developed intestinal obstruction. The cumulated incidence was 0.33% after 30 days, 0.79% after 1 year, and 1.51% after 14 years. Female sex as compared with male sex (RR = 3.91; 95% confidence limits (CL), 1.25-12.0) and removal of a removal of a normal appendix as compared with an inflamed appendix (RR = 4.0; 95% CL, 1.28-12.5) carried a significantly higher risk of intestinal obstruction.


CONCLUSIONS
Intestinal obstruction after open appendectomy is rare.
Riber
C
C
Dept. of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen, Denmark.
Søe
K
K
Jørgensen
T
T
Tønnesen
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects*; D001065:Appendix / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D007416:Intestinal Perforation / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012737:Sex Factors; D013997:Time Factors