title: Laparoscopic appendectomy for chronic right lower quadrant abdominal pain.
abstract: OBJECTIVE
  The appendix can be a rare cause for chronic right lower quadrant abdominal pain (RLQAP), even though no objective disorder can be determined to the appendix. This condition can be described as chronic appendicitis or (neurogenic) appendicopathy. After careful selection, elective appendectomy is performed in our centre for this group of patients.
  
  
  METHODS
  All patients that underwent an elective appendectomy between 2006 and 2013 were prospectively analysed. Inclusion criterion was chronic RLQAP without abnormalities seen on imaging. Exclusion criterion was pain after conservative treatment of (complicated) appendicitis or an abnormal appendix on imaging like a mass, mucocoele or faecolith. Primary outcome was the effect on the pain postoperatively.
  
  
  RESULTS
  In the period of the study, ten patients met the inclusion criteria and underwent an appendectomy for chronic RLQAP. Average preoperative pain score assessed with visual analogue scale (VAS) was 8.6. Preoperative work-up showed no abnormalities. No macroscopic abnormalities were seen during surgery in any of the patients. Histopathological analysis was obtained and showed limited abnormalities in eight of ten patients, mostly suspicion of previous inflammation. Postoperatively, no complications occurred, and at revision after 3 weeks, average VAS was 1.0. Long-term follow-up showed that patients remained free of symptoms; average VAS after a median of 33 months was 1.0.
  
  
  CONCLUSIONS
  A significant reduction of pain was achieved after an appendectomy in all patients suffering from chronic RLQAP in this series. Seven out of ten patients were completely free of pain.
authors: Department of Surgery, Tergooi Hospital, PO Box 10016, 1201 DA, Hilversum, The Netherlands, charlesvanrossem@hotmail.com.
authors: Charles C
authors: CC
authors: van Rossem
authors: Kaij
authors: K
authors: Treskes
authors: David L
authors: DL
authors: Loeza
authors: Anna A W
authors: AA
authors: van Geloven
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery*; D000208:Acute Disease; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000150:complications / Q000601:surgery; D001065:Appendix / Q000601:surgery; D002429:Cecal Diseases / Q000150:complications / Q000601:surgery; D002908:Chronic Disease; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies