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 .
Safety of incidental appendectomy.
Reports in the surgical literature are conflicting as to whether appendectomy " in passing " during laparotomy for trauma or for some other disease state does or does not significantly increase patient morbidity or mortality . A chart survey of all appendectomies ( 342 for acute appendicitis and 146 as incidental procedures ) performed on the trauma service of Grady Memorial Hospital over a 40 month period appeared to indicate that the wound infection rate ( 6.8 percent ) was the same as that for acute simple or suppurative appendicitis ( 6.7 percent ) , whereas the intraabdominal sepsis rate ( 17.5 percent ) paralleled that for more advanced gangrenous or perforative appendicitis ( 18.6 percent ) . Since the validity of a retrospective review is always open to question , a prospect i ve , r and omized trial was carried out only on patients with a negative abdominal exploration for trauma over a 22 month interval at the same trauma service . An odd second from the last digit hospital number dictated appendectomy , provided the appendix was readily accessible ; an even digit in the same locus dictated retention of the appendix . In no patient did intraperitoneal sepsis develop , regardless of the procedure chosen . Wound infection rates were 1.8 percent for appendectomy ( 1 of 56 ) , if local anatomic considerations precluded an easy appendectomy ( 0 of 45 ) , and 3.6 percent for the control subjects without appendectomy ( 3 of 83 ) . There were no deaths . These data cast considerable doubt on the reliability of retrospective review s and support the generally accepted dictum that incidental appendectomy , especially in the trauma patient , can be a relatively innocuous procedure
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 .