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SUMMARY Age-specific appendicectomy rates for Ireland have recently been reported to be substantially higher than those for Scotland. We attempted to determine the reason for this difference. Records of 940 appendicectomies performed in one urban and one rural centre in Ireland over a 12 month period were examined to establish the frequency of acute appendicitis. Appendicitis rates were derived from these data. Appendicectomy rates are higher in Ireland because the incidence of acute appendicitis is greater than in Scotland or England and Wales and are not the result of variations in medical practice.Age-specific appendicectomy rates derived from Hospital In-Patient Enquiry (HIPE) statistics for the Republic of Ireland are 1.5 to 2-0 times greater than comparable rates for Scotland' (see table). We attempted to determine whether these differences are due to variations in medical practice or to intrinsic differences in the incidence of acute appendicitis in the two countries.

Intrarenal scatter of stone fragments during percutaneous nephrolithotripsy is a complication which may predispose to post-operative pain and further stone formation. The use of a coagulum to prevent such a complication has proved difficult when introduced percutaneously. This experimental study describes a new gelatine (Lithogel) which is introduced through the nephroscope to coat the renal calculus; it allows easy disintegration of the calculus within the gel, is safe to use and effectively prevents the scatter of fragments into inaccessible calices.

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