Chronic and recurrent appendicitis

Acute appendicitis is a well known clinical entity, but many physicians are unwilling to accept appendicitis as a chronic or recurrent illness. Of 225 patients undergoing appendectomy, sixteen (7 per cent) had findings suggestive of chronic, recurrent, or subacute appendicitis. Four patients had chronic abdominal pain and histologic findings of chronic inflammation. Nine patients had previous episodes similar to that which resulted in appendectomy. All had acute suppurative appendicitis pathologically. Three patients had only one episode of abdominal pain, but had pathologic evidence of subacute inflammation. Because this study was retrospective, we suspect that the true incidence of recurrent appendicitis is significantly greater, as reported by others. Indications for operation must be strict, for unless there are specific signs and symptoms of appendiceal disease, appendectomy will often be of no benefit.