"Appendicitis" in Young Women

Lee, J.A.H.

doi:10.1016/s0140-6736(61)91103-5

Cited by 34 publications

(12 citation statements)

References 5 publications

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“…1 confirms the findings of Lee (1961) 25, and of Harding (1962) in that only 40% of the appendices removed were diseased. Of the elective appendicectomies 11% were diseased ; of the emergency appendicectomies 5100 were diseased.…”

Section: Resultssupporting

confidence: 84%

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Right Iliac Fossa Pain in Young Women. With Appendix on the Cornell Medical Index Health Questionnaire

Oppenheim¹

1965

BMJ

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In 1958 we became concerned that a large number of the young female patients (over the age of 15) being submitted to appendicectomy were found to have normal appendices. We were also interested that this situation did not seem to apply to young male patients in the same age-group.A study of the literature available at that time did nothing to augment our knowledge or assuage our curiosity, but merely substantiated that " appendicitis " is more common in young women than in young men. This situation, however, was so only after puberty and was not found in childhood (Lee, 1961). There was wide variation in the reported cure rate after operation for chronic appendicitis: Alvarez (1940) gave 4000, Gallagher and Stevenson (1955) 87%, andOsborne (1959) 57%. Thackray (1959) compared the histology of appendices removed for "chronic appendicitis " and those removed incidentally during gynaecological operations. He found no differences in the two groups, each having a similar number of diseased and normal appendices.Harding (1962) found that of 369 appendices removed for "acute appendicitis" from female patients aged 11 to 30 59% were histologically normal.These papers and the correspondence they led to in the medical press emphasized the problem but did nothing to explain its causes. Many suggestions on aetiology were advanced but were unsubstantiated. Scope of InvestigationsIt was planned to study all those young women who presented in the out-patient department and/or were admitted electively with symptoms of recurrent pain in the right iliac fossa, and those who were admitted as emergencies with " acute appendicitis " but found to have healthy appendices, to try to discover, where all organic disease had been excluded, what, if any, other factors-for example, social and emotional-might be operating. By comparing the findings with those on all young women admitted and operated on for proved appendicular disease it was hoped to learn whether there were any differences between the two groups which might be significant as diagnostic criteria. Further, by planning a prospective study, the aim was to follow the patients for a reasonably long period in order to assess the long-term effect of appendicectomy in both groups.The investigations were limited to one surgical unit with 13 female beds. The unit is responsible for receiving all surgical emergencies every third week. MethodsClinical.-All patients included in the study were investigated and treated clinically in the usual way. Where surgery was performed all the appendices were subject to pathological investigations, except where the appendix at operation was so obviously diseased as to leave the diagnosis in no doubt. Only those appendices which showed no abnormality of any kind, both macroscopically and histologically, were regarded as normal (Harding, 1962).Social.-A detailed analysis of the social and emotional factors and their relation to the clinical findings proved difficult to do. Every effort was made to make the appraisal of the facts presented as objec...

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Section: Resultssupporting

confidence: 84%

“…This situation, however, was so only after puberty and was not found in childhood (Lee, 1961). There was wide variation in the reported cure rate after operation for chronic appendicitis: Alvarez (1940) gave 4000, Gallagher and Stevenson (1955) 87%, and Osborne (1959) 57%.…”

mentioning

confidence: 99%

Right Iliac Fossa Pain in Young Women. With Appendix on the Cornell Medical Index Health Questionnaire

Oppenheim¹

1965

BMJ

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“…Barnes, Behringer, Wheelock, and Wilkins (1962) found that 25.3% of 7,810 appendices removed at the Massachusetts General Hospital between 1937 and 1955 were normal. From an analysis of figures supplied by the General Register Office giving the number of patients discharged from hospitals with a diagnosis of appendicitis in 1956 and 1957, Lee (1961) showed that twice as many young women aged 17 years were thus diagnosed than might be expected. He noted that although these cases had been discharged with a diagnosis of "appendicitis" there was no information about the histological findings, and he believed that the extra cases in young women were probably not due to inflammation of the vermiform appendix as commonly understood.…”

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confidence: 99%

A Notable Source of Error in the Diagnosis of Appendicitis

Harding¹

1962

BMJ

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“…HIPE AS A SOURCE OF MORBIDITY DATA HIPE was conceived primarily as a source of information about morbidity but it is self-evident that illness managed in hospitals is, for the majority of diseases, a selected fraction (Morris, 1957;World Health Organisation, 1968) the dimensions of which are governed by a variety of factors (Uemura, 1970). For a few conditions, however, and in the initial report appendicitis was specified as an example (MacKay, 1951), hospital admissions can measure virtually total morbidity.…”

Section: The Hospital In-patient Enquirymentioning

confidence: 99%

“…Even these two rather crude indicators taken together may, however, be of some considerable significance. Differences in 'case-fatality rates', for many common conditions, between teaching and Regional Board hospitals are now of long standing (Lee, Morrison, and Morris, 1957;Lipworth, Lee, and Morris, 1963).…”

Section: Admission Ratesmentioning

confidence: 99%

Present state of statistics from hospital in-patient data and their uses.

Ashley¹

1972

Journal of Epidemiology & Community Health

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"Appendicitis" in Young Women

Cited by 34 publications

References 5 publications

Right Iliac Fossa Pain in Young Women. With Appendix on the Cornell Medical Index Health Questionnaire

Right Iliac Fossa Pain in Young Women. With Appendix on the Cornell Medical Index Health Questionnaire

A Notable Source of Error in the Diagnosis of Appendicitis

Present state of statistics from hospital in-patient data and their uses.

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