DOI: http://dx.doi.org/10.18203/2349-2902.isj20173873

Impact of post appendectomy pain

Yashwant R. Lamture, Varsha P. Gajbhiye, R. K. Shinde, Kher Kiran

Abstract


Background: Appendectomy is one of the commonest abdominal operation performed during emergency hours for acute appendicitis. Acute appendicitis is the common pathology in right lower abdomen. Postoperative complications following appendicectomies are not uncommon and reflect the degree of peritonitis that was present at the time of operation. Intra operative spillage and intercurrent diseases that may predispose to the complication. But all patients are not relieved of their symptoms following surgery. Few patients continue to visit surgical OPD for continuous pain in right iliac fossa even after appendectomy had been performed. So, we design proforma to find out exact cause of pain. This study is a sincere effort on our part to solve secrets of post appendectomy pain.

Methods: Evaluation of patient who continue to visit even after removal of appendix for pain in right iliac fossa. It was tried to establish correlation between relief of pain and histopathology report of appendix to justify the appendicectomies. These patients investigated to find out underlying organic cause. Functional patients were subjected for psychological evaluation.

Results: In present study from June 2006 to August 2008 we enrolled around 30 patients with complaints of pain in right iliac fossa even after appendectomy. 60% were female and 40% were male in a present study. Out of 30 cases 24 patient means 80%, were in the age group of 20 to 40 years. We found one patient means 3.33% with clinical diagnosis of stump appendicitis on radiological (barium meal follows through) examination was confirmed who responded to conservative line of treatment. All patients presented with pain in right iliac fossa symptom was the criteria for selection of patients. Exception of single patient of stump appendicitis rest were having other treatable causes.

Conclusions: Out of 30 patients only one patient was having actual stump appendicitis. It is not correct to say that post appendectomy pain is a complication of surgical procedure, as multiple treatable causes were found in 29 patients. Study demonstrated that most of these patients really had organic disease. Only two patients were simple victims of psychosomatic pain. This study enlightened nicely regarding various delayed complications of appendectomy.


Keywords


Adenocarcinoma, Carcinoma, Colonoscopy, Colorectal, Retrospective

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References


Ahmed M. Al-Hashemy, Seleem MI, Appraisal of the modified Alvarado score for acute appendicitis in adults. Saudi Med J. 2004;25(9):1229-31.

Smink DS, Soybel DI. Appendix and appendectomy. Zinner MJ, Ashley SW. Maingot’s Abdominal Operations. 11th ed. NewYork: The McGraw-Hill. 2007:589-611.

Williams NS, Bulstrode CJK, P Ronan. The vermiform appendix, Bailey and love's short practice of surgery. London: hodder Arnold; 2004;24:1203-18.

Wass SH. Chronic pain in right iliac fossa. Br Med J. 1986;2:234-6.

Friedlich MS, Papadatos D. Acute appendagitis as a cause of right lower quadrant pain. Canadian J Surg. 2006;49(3):215.

Pieper R, Kager L, Näsman P. Acute appendicitis: a clinical study of 1018 cases of emergency appendectomy. Acta Chirurgica Scandinavica. 1982;148(1):51.

Green JM. Incomplete removal of appendix and its complications. J College Surg. 1958;29:141.

Khairy G. Acute appendicitis: is removal of a normal appendix still existing and can we reduce its rate?. Saudi J Gastroenterol. 2009;15(3):167-70.

D Birchley. Patients with clinical acute appendicitis should have pre-operative full blood count and c-reactive protein assays. Ann R Coll Surg Engl. 2006;88:27-32.

Ibrahim M, Sak M, Kreshnan TR, Sharma R, Abdel-Shaheed AA, Habib MA. Ultrasonography in the diagnosis of clinically equivocal acute appendicitis: a prospective study. Kuwait Med J. 2003;35(3):271-4.

Williams GR. A history of appendicitis. Annals Sur. 1983;197(5):495-506.

Berr J, Malt RA. Appendicitis near its centenary. Ann Surg. 1984;200:5567-75.

13. Stephen R. T. Evans, Appendicitis 2006,Ann Surg. 2006 Nov; 244(5): 661–662.

Bhasin SK, Kumar V, Mahajan M, Kumar R. A comparative study of mini-appendectomy and conventional-appendectomy in acute appendicitis. JK Sci. 2012;14(4).

Goode JV. Management of appendiceal stump. Annals Surg. 1943;13:956-63.