Five year follow up of females admitted with acute right iliac fossa pain: does initial intervention influence repeat admission?

Diagnostic laparoscopy increases the rate of reaching a specific diagnosis and reduces the normal appendectomy rate in females of reproductive age. However, few studies examine long term outcomes. The aim of this study was to assess rates of re-admission to hospital over a 5-year period in females of reproductive age following an index admission with acute RIF pain that was not due to appendicitis. Female patients aged between 14 and 50, admitted with acute RIF pain over a 6-month period were selected for follow up. Patients with a diagnosis of acute appendicitis on the index admission were excluded. Repeat admissions to hospital and results of repeat surgical interventions were assessed through examination of patient charts and hospital records. Patients were grouped according to management on the index admission: no operative management (n = 49), diagnostic laparoscopy (n = 21) and laparoscopy with laparoscopic removal of a macroscopically and histologically normal appendix (n = 14). Median follow up was 5 years. Rates of re-admission were greatest in the group who underwent a diagnostic laparoscopy on the index admission (52 %) (p\0.001). Similarly, this group had the highest rate of subsequent operative intervention with seven patients (33 %) undergoing a repeat laparoscopy at which a normal appendix was removed in five patients (p = 0.001). Females of reproductive age who undergo a diagnostic laparoscopy have a higher rate of subsequent re-admission with recurrent RIF pain in the medium term than similar patients who have a normal appendix removed at index admission or those who undergo clinical observation only.