Dr Ching-Liang Lu and colleagues from Taiwan prospectively examined whether irritable bowel syndrome (IBS) is associated with negative appendectomy.
The research team also evaluated whether psychiatric profiles, health-related quality of life and clinical features are associated with negative appendectomy.
The team evaluated 430 patients from an inpatient and emergency service in a university-affiliated teaching hospital.
|Absence of migrating pain also predicted negative appendectomy|
The patients underwent emergent surgery for suspected appendicitis.
The team used the Rome-II irritable bowel syndrome questionnaire, and the Hospital Anxiety and Depression Scale.
The researchers also applied the Short-Form 36 survey, and assessed the clinical, pathological and computerized tomography findings.
The researchers identified 68 patients in the negative appendectomy group.
The team observed that the negative appendectomy group was younger, with female predominance.
This group also had a higher prevalence of Rome-II irritable bowel syndrome, and higher anxiety or depression scores.
The researchers observed that patients with a negative appendectomy had lower levels of health-related quality of life than the positive appendectomy group.
The team found the patients with negative appendectomy tended to have atypical presentations, such as absence of migration pain, fever, or muscle guarding.
The negative appendectomy group also had lower white cell count and percentage of polymorphonuclear cells, and a lower rate of computerized tomography scan usage.
The team found after multiple logistic regression, that irritable bowel syndrome, degree of anxiety were independent predictors of negative appendectomy.
Absence of migrating pain, muscle guarding, and a lower polymorphonuclear cells percentage were independent factors predicting negative appendectomy.
In addition, the team noted that no computerized tomography scan usage was an independent factors in predicting negative appendectomy.
Dr Lu's team concluded, "Both patient, and physician factors are the independent determinants predicting negative appendectomy."
"Physicians should be cautious before operating on or referring patients with irritable bowel syndrome for appendectomy."
"Computerized tomography scan should be considered in patients with suspected appendicitis, particularly in those with irritable bowel syndrome and atypical clinical presentations."