Atopy is a risk factor for acute appendicitis? A prospective clinical study.
OBJECTIVE
The purpose of the study was to assess the role of atopy on the development of appendicitis. Acute appendicitis is the most common indication for emergent laparotomy especially in the late teens and early 20s. The pathogenesis generally begins with luminal obstruction caused by fecal mass, seeds, stricture, and bacterial, parasitic, or viral infections. The present study was designed to evaluate whether allergic reaction is indeed an undefined leading factor for luminal obstruction.


METHODS
Mix inhalant and food prick tests were performed in 111 patients who underwent appendectomy for acute appendicitis and in 100 control patients. The material of appendectomy was examined, acute appendicitis was verified and graded according to the severity of inflammation and eosinophilic infiltration rate in the wall of appendix by a pathologist. Demographic data were recorded, and peripheral eosinophil count was also performed.


RESULTS
Mix prick test of 33 patients (29.7%) and food prick test of 14 patients (12.6%) were positive in study group when compared with 7 patients (7%) and 1 patient (1%) in control group (p < 0.001). A total of 38 patients (34.2%) in the study group were reactive with mix or food prick test when compared with 8 patients (8%) in control group. There was no significant difference between eosinophilic infiltration rate, peripheral eosinophil count, severity of inflammation, and Alvarado score of mix prick test positive and negative patients in study group.


CONCLUSIONS
Atopy incidence in patients with acute appendicitis was significantly higher when compared with control group. However, eosinophilic infiltration rate, inflammation grade, and peripheral eosinophil count were not able to explain the relationship between the two conditions. Atopy is a risk factor for acute appendicitis.
Harlak
Ali
A
Department of General Surgery, Gulhane Military Medical Academy (GATA), 06018 Etlik, Ankara, Turkey. aharlak@yahoo.com
Gulec
Mustafa
M
Mentes
Oner
O
Kilbas
Zafer
Z
Onguru
Onder
O
Acikel
Cengizhan
C
Caliskaner
Zafer
Z
Erel
Fuat
F
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods; D001064:Appendicitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000209:etiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012882:Skin Tests; D016896:Treatment Outcome