Are acute exacerbations of chronic inflammatory appendicitis triggered by coprostasis and/or coproliths?
OBJECTIVE
To examine the role of coprostasis and coproliths in recurrent appendicitis.


METHODS
We evaluated four hundred and twenty seven consecutive pathology reports of all appendectomy specimens from January 2003 to December 2004. Findings were categorised as showing acute appendicitis, acute recurrent appendicitis, subacute recurrent appendicitis, chronic appendicitis, or appendices without inflammation. All patients had presented with acute right lower quadrant pain. In 94 instances, there was a history of recurrent similar episodes in the past.


RESULTS
Of the 427 histology reports, 294 were inter-preted as showing acute appendicitis, 56 acute recurrent appendicitis, 34 subacute recurrent appen-dicitis, 28 chronic appendicitis, and 15 non-inflamed appendices. Coprostasis was observed in 58 patients (13.58%) and the presence of coprolith in 6 (1.4%). Coprostasis, and age, were among the predictors in the final model.


CONCLUSIONS
Coprostasis but not coproliths seems to be a contributing factor to acute exacerbations of chronic inflammatory appendicitis.
Sgourakis
George
G
Department of General, Visceral, and Transplantation Surgery, Essen 45122, Germany. ggsgourakis@yahoo.gr
Sotiropoulos
Georgios C
GC
Molmenti
Ernesto P
EP
Eibl
Charis
C
Bonticous
Stylianous
S
Moege
Jurgen
J
Berchtold
Christoph
C
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D001064:Appendicitis / Q000145:classification / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001065:Appendix / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005244:Fecal Impaction / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D009626:Terminology as Topic