title: Incidental appendectomy? Microscopy tells another story: A retrospective cohort study in patients presenting acute right lower quadrant abdominal pain.
abstract: BACKGROUND
  Optimal management of macroscopically normal appendix encountered during laparoscopy for acute abdominal pain is still unclear.
  
  
  METHODS
  164 acute abdominal pain cases in which laparoscopy showed a normal appendix were reviewed. No other intra-peritoneal acute disease was present in 50 patients (Group 1) whereas a miscellanea of intra-peritoneal conditions was identified in the other 114 (Group 2). All the patients underwent appendectomy with specimen examination.
  
  
  RESULTS
  Following incidental appendectomy significant microscopical changes were seen in 125 specimens (76%). Among these, inflammation was found in 122 and neuroendocrine tumors in 3. Appendices harbored pathological changes in n = 45 patients (90%) of Group 1 and in n = 34 patients (70%) of Group 2 patients (p < 0.05). Morbidity for incidental appendectomy was 2%.
  
  
  CONCLUSIONS
  This study supports an appendectomy in patients who are undergoing laparoscopy for acute right lower quadrant abdominal pain even when the appendix appears normal on visual inspection.
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Tartaglia
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy. Electronic address: andreabertolucci83@hotmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bertolucci
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Galatioto
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Palmeri
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Di Franco
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Fantacci
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Furbetta
authors.affiliation: Emergency Surgery Unit, University of Pisa, Pisa, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiarugi
mesh_terms: D015746:Abdominal Pain / Q000601:surgery*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Abdominal pain; Appendicitis; Laparoscopic appendectomy; Normal appendix