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Case Reports in Medicine
Volume 2014 (2014), Article ID 292864, 3 pages
http://dx.doi.org/10.1155/2014/292864
Case Report

Prophylactic Appendectomy during Laparoscopic Surgery for Other Conditions

Arcispedale Sant’Anna, Department of Surgery, Emergency Surgery Service, Via Aldo Moro 8, Cona, 44124 Ferrara, Italy

Received 6 May 2014; Revised 4 July 2014; Accepted 7 July 2014; Published 20 July 2014

Academic Editor: T. A. Salerno

Copyright © 2014 S. Occhionorelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute appendicitis remains the most common surgical emergency. Laparoscopy has gained increasing favor as a method of both investigating right iliac fossa pain and treating the finding of appendicitis. A question arises: what to do with an apparent healthy appendix discovered during laparoscopic surgery for other pathology. We present a case of unilateral hydroureteronephrosis complicated with rupture of the renal pelvis, due to gangrenous appendicitis with abscess of the right iliopsoas muscle and periappendicular inflammation in a 67-year-old woman, who underwent laparoscopic right annessiectomy for right ovarian cyst few years earlier, in which a healthy appendix was left inside. There is a lack of consensus in the literature about what to do with a normal appendix. The main argument for removing an apparently normal appendix is that endoluminal appendicitis may not be recognized during surgery, leading to concern that an abnormal appendix is left in place. Because of a lack of evidence from randomized trials, it remains unclear whether the benefits of routine elective coincidental appendectomy outweigh the costs and risks of morbidity associated with this prophylactic procedure. Nevertheless, it appears, from limited data, that women aged 35 years and under benefit most from elective coincidental appendectomy.