[Chronic recurrent appendicitis: a contradiction in terms?]

Abstract

For two years, every 6 weeks a 23-year-old man presented with episodes of severe abdominal pain and fever. After an extensive diagnostic workup, showing only slightly increased infectious parameters during the pain attacks and infiltration around the terminal ileum, a diagnostic laparoscopy diagnosed 'chronic recurrent appendicitis'. A 40-year-old female had severe attacks of abdominal pain and fever every 4-6 weeks for 1.5 years. Some inflammation around the appendix was seen on colonoscopy, and a diagnostic laparoscopy finally confirmed the same diagnosis 'chronic recurrent appendicitis'. Patients with recurrent abdominal pain often are a diagnostic challenge for the clinician. The appendix is rarely recognized as the causative factor and the diagnosis 'chronic recurrent appendicitis' is not widely accepted. This disease entity often has an atypical presentation and well-defined criteria are lacking. In this article we plea for a broader acceptance of this diagnosis, which, in our opinion, deserves to be included in the differential diagnosis of longstanding or recurrent abdominal pain attacks.