Consequences of removal of a “normal” appendix

Five hundred consecutive cases of appendicectomy were reviewed. The incidence of non-inflamed appendices removed at operation was 29.6% and was nearly twice as high in females than in males (P< 0.001). The incidence of perforated appendices in patients with acute appendicitis was low (6.5%), and there were no deaths. Postoperative complications, mostly infections, occurred in 6.7% of patients with a non-inflamed appendix and in 19.3% of patients with appendicitis (P< 0.001). No features of the history or examination were sufficiently discriminatory to enable a definite diagnosis to be reliably established before operation. Appendicectomy remains the safest management option in patients with suspected appendicitis in whom diagnostic doubt remains after thorough clinical evaluation and observation.