title: Clinical, ultrasonographic, and pathologic characteristics of patients with chronic right-lower-quadrant abdominal pain that may benefit from appendectomy.
abstract: BACKGROUND
  Chronic pains of the right lower quadrant of the abdomen (RLQA) remain a challenging problem worldwide, especially in areas with limited technical background; chronic appendicitis is still a subject of controversy. The aim of this study was to analyze the clinical and paraclinical data of patients with chronic pains of RLQA who had an appendectomy performed.
  
  
  METHODS
  During a period of 4 years, all patients presenting with a chronic pain of the RLQA were selected for our study and underwent clinical assessment and systematic ultrasonography of the abdomen; these served as a basis of selecting candidates for appendectomy. The intraoperative findings, histology results, and outcome after appendectomy were analyzed.
  
  
  RESULTS
  Three hundred nineteen patients presented with chronic pains of the RLQA of which 213 could be finally analyzed; their mean age was 15.3 years; 192 patients were females. They had pains for 2-8 years. Echography showed a heterogeneous lesion in the RLQA in 87% of the cases. The operative findings displayed adhesions and other signs of chronic inflammation in 182 cases. Pathological analysis frequently revealed fibrosis and lymphoplasmocytic infiltration indicative of chronic inflammation. Eighty-seven percent of the patients were cured by appendectomy.
  
  
  CONCLUSIONS
  There is a chronic process involving the appendix that occurs in the RLQA of patients with chronic pains, typically the adolescent female. Appendectomy usually solves the problem. The criteria for selection of candidates still need to be identified, but in the absence of laparoscopic facilities, we recommend appendectomy when no other cause for the pain has been identified.
authors.affiliation: University of Buea and Regional Hospital, Limbe, South West Region, Cameroon. alainchichom@yahoo.com
authors.forename: Alain
authors.initials: A
authors.lastname: Chichom Mefire
authors.forename: Robert
authors.initials: R
authors.lastname: Tchounzou
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kuwong
authors.forename: Jean P A
authors.initials: JP
authors.lastname: Atangana
authors.forename: Albert C
authors.initials: AC
authors.lastname: Lysinge
authors.forename: Eimo E
authors.initials: EE
authors.lastname: Malonga
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D002163:Cameroon; D002648:Child; D002908:Chronic Disease; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010808:Physical Examination / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D055815:Young Adult