Morbidity was minimal at all ages .
: The data from the current survey and literature review support incidental removal of the appendix in the young patient ( < 35 years old ) .
However , routine incidental appendectomy can not be justified in patients greater than age 50
The results of the two review s were analyzed to formulate guidelines for the appropriateness of performing incidental appendectomy in association with other operative procedures .
Acute appendicitis—a clear-cut case in men, a guessing game in young women

Abstract Background : The aggressive surgical approach to patients suspected of having acute appendicitis for fear of perforation , and the inaccuracy of available diagnostic methods lead to an unacceptably high negative appendicectomy rate , especially in young women , in whom gynecological disorders frequently mimic appendicitis . Our objectives were to determine the value of diagnostic laparoscopy in women of child-bearing age to reduce the number of negative laparotomies and establish the correct diagnosis to allow prompt and appropriate treatment . Methods : 161 consecutive adult female patients under 50 years of age with a clinical diagnosis of acute appendicitis underwent diagnostic laparoscopy  prior to the planned appendicectomy .  If an inflamed appendix was found , appendicectomy was usually done through a muscle-splitting McBurney incision . Other diagnoses were treated accordingly . A normal appendix was not removed . Results were compared to a group of 42 similar patients in whom the laparoscopy was omitted for various reasons , to 23 postmenopausal women , and to all 137 male adults , directly operated by the McBurney approach .  Results : After laparoscopy , 55 % of the patients required  appendicectomy  for appendicitis while in 23 % a gynecological diagnosis was made in spite of previous examination by a gynecologist . Fourteen percent had a negative laparoscopy . There were no false-negative results . The negative appendicectomy rate after laparoscopy was 5 % due to two false positives and eight laparoscopy failures . In the group of fertile females who escaped laparoscopy the negative appendicectomy rate was 38 % . The respective rates for postmenopausal women and men were 4 % and 8 % . Conclusions : All women of child-bearing age suspected of having acute appendicitis should undergo diagnostic laparoscopy prior to the planned appendicectomy , regardless of the certainty of the preoperative diagnosis . This is currently the only way to reduce the negative appendicectomy rate and establish a correct diagnosis allowing prompt and appropriate treatment . In male patients and postmenopausal women one may proceed directly to emergency appendicectomy
Morbidity was minimal at all ages .
: The data from the current survey and literature review support incidental removal of the appendix in the young patient ( < 35 years old ) .
However , routine incidental appendectomy can not be justified in patients greater than age 50
The results of the two review s were analyzed to formulate guidelines for the appropriateness of performing incidental appendectomy in association with other operative procedures .