부산대학교 도서관

Background: We sought to determine the association between the presence of a fecalith and acute/nonperforated appendicitis, gangrenous/perforated appendicitis and the healthy appendix. Methods: We retrospectively analyzed appendectomies performed between October 2003 and February 2012. We collected data on age, sex, appendix histology and the presence of a fecalith. Results: During the study period, 1357 appendectomies were performed. Fecaliths were present in 186 patients (13.7%). There were 94 male (50.5%) and 92 female patients, and the mean age was 32 (range of 10-76) years. The fecalith rate was 13%-16% and was nonexistant after age 80 years. The main groups with fecaliths were those with acute/nonperforated appendicitis (n = 121, 65.1%, p = 0.041) and those with a healthy appendix (n = 65, 34.9%, p = 0.003). The presence of fecaliths in the gangrenous/perforated appendicitis group was not significant (n = 19, 10.2%, p = 0.93). There were no fecaliths in patients with serositis, carcinoid or carcinoma. Conclusion: Our data confirm the theory of a statistical association between the presence of a fecalith and acute (nonperforated) appendicitis in adults. There was also a significant association between the healthy appendix and asymptomatic fecaliths. There was no correlation between a gangrenous/perforated appendix and the presence of a fecalith. The fecalith is an incidental finding and not always the primary cause of acute (nonperforated) appendicitis or gangrenous (perforated) appendicitis. Further research on the topic is recommended. Contexte: Nous avons voulu examiner le lien entre la presence d'un fecalome et l'appendicite aigue/non perforee, l'appendicite gangreneuse/perforee et un appendice sain. Methodes: Nous avons analyse de maniere retrospective les appendicectomies effectuees entre octobre 2003 et fevrier 2012. Nous avons recueilli des donnees sur l'age, le sexe, l'histologie de l'appendice et la presence d'un fecalome. Resultats: Durant la periode de l'etude, 1357 appendicectomies ont ete effectuees. Des fecalomes etaient presents chez 186 patients (13,7%). L'etude regroupait 94 hommes (50,5%) et 92 femmes; l'age moyen etait de 32 ans (entre 10 et 76 ans). Le taux de fecalome etait de 13% a 16% et non existant apres l'age de 80 ans. Les principaux groupes porteurs de fecalomes etaient ceux qui presentaient une appendicite aigue/non perforee (n = 121, 65,1%, p = 0,041) et ceux dont l'appendice etait sain (n = 65, 34,9%, p = 0,003). La presence de fecalomes dans le groupe souffrant d'appendicite gangreneuse/perforee s'est revelee non significative (n = 19, 10,2%, p = 0,93). Les patients qui souffraient de serosite, de carcinoide ou de carcinome ne presentaient pas de fecalomes. Conclusion: Nos donnees confirment la theorie d'un lien statistique entre la presence d'un fecalome et une appendicite aigue (non perforee) chez l'adulte. On a egalement observe un lien significatif entre un appendice sain et des fecalomes asymptomatiques. On n'a observe aucune correlation entre un appendice gangreneux/ perfore et la presence de fecalomes. Le fecalome est une observation accessoire qui n'est pas toujours la principale cause de l'appendicite aigue (non perforee) ou de l'appendicite gangreneuse (perforee). Une recherche plus approfondie a ce sujet est recommandee.
It is generally accepted that the main etiology of appendicitis is obstruction due to fecalith in adults and lymphoid hyperplasia in children. It is also accepted that perforated/gangrenous appendicitis is [...]