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April 1964

Incidental Appendectomy With Regional EnteritisAdvisability

Author Affiliations

From the Department of Surgery, University of California Medical Center, and the Wadsworth General Hospital, Veterans' Administration Center.

Arch Surg. 1964;88(4):546-551. doi:10.1001/archsurg.1964.01310220036007

In 1935 Erb and Farmer1 reported on four patients who had had the signs and symptoms of acute appendicitis, but who proved at exploration or autopsy to have been suffering from ileitis or ileocolitis. They recognized then that these four cases represented still another of the protean manifestations of the disease first described by Crohn and associates2 three years earlier. They performed an appendectomy on two of the four patients whose appendices were normal in appearance. Although they reported no unfortunate sequelae to the appendectomies, other surgeons have not been so favored. The incidence of fecal fistulae to the incisional site following appendectomy in the presence of regional enteritis has been reported as high as 25.6% by Colcock and Vansant3 at the Lahey Clinic. Members of that clinic4 and others5 have frequently stated that the appendix should never be removed in such circumstances, but rather

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