Appendicectomy in childhood: pathology found.

A review of the operation and pathology reports from 500 consecutive childhood appendicectomies by one surgeon revealed true acute appendicitis in 64% of patients, other pathology in 19.8% and normal operation findings and histology in 16.2%. When a normal appendix was found at operation, search of the adjacent peritoneal cavity produced a positive yield in 14% of searches, including abnormality in the small bowel in 4%, in the omentum or mesentery in 3% and in the female pelvic organs in 7%. Of appendices deemed normal by the surgeon 8.7% were histologically inflamed and of those deemed inflamed by the surgeon 3.5% were histologically normal. These figures emphasize the need for a more critical approach to the diagnosis of appendicitis both pre- and peroperatively and of the importance of histological examination of the organ.