In order to reduce the misdiagnosis of the appendicitis and to avoid unnecessary appende-ctomy, authors reviewed 639 cases of appendectomies performed at the department of surgery, Keimyung University, school of medicine from January 1, 1981 through June 30, 1983, retro-spectively.
The following results were obtained:
1) Of the 639 cases, 72 cases were turned out to be normal appendix pathologically, so the rate of the misdiagnosis was 11.3%. The frequency of the misdiagnosis was most prevalent in males below the age of 10 and between the ages 11 to 20 in females.
2) The rates of leukocytoosis above 10, 000/mm3 and increase of segment neutrophils over 80% were noted in 89.2% and 91.5% of the proven appendicitis cases (group 2 patients) res-pectively. But group 4 patients (pathologically normal appendix and has no other pathology in abdominal cavity) showed only 8.3% of leukocytosis.
3) Of the total 639 cases, only 570 cases were able to analyze the shifting of the abdominal pain by reviewing the chart and 53.3% of the appendicitis cases (group 2) had shifting of pain in their history. But group 4 patients also had pain shifting in 40%, and the difference was not significant.
4) Most of the periappendiceal abscess patients had their symptoms more than seven days before they received appendectomy and there were more advanced forms of appendicitis among patients with prolonged history of symptoms.
5) Of the 72 normal appendix patients, acute mesenteric lymphadenitis was most common cause of abdominal pain, especially in childhood. Other diagnosis that were confirmed after operation were pelvic inflammatory disease, enteritis, cystitis, ovarian cyst, normal pregnancy, renal stone, ascariasis, primary peritonitis, typhoid enteritis, ectopic pregnancy, cecal malig-nancy, intestinal tuberculosis, inadequate previous appendectomy and perforated duodenal ulcer in decreasing order. But in 12 cases, there was no definite pathology found during the operation and the symptoms of the preoperative period disappeared following surgery.
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