IIRC, from medical school days:
the natural history of untreated appendicitis is
33% resolve spontaneously
33% rupture with formation of appendix abscess
33% rupture with acute peritonitis & death
Therefore,
seems perfectly feasible that a few cases of genuine
appendicitis will recover on their own, without medical
attention or a formal diagnosis, and may then present
at a later date with clinical picture of acute appendicitis.
<Anecdote warning!!>
Had a fit sensible chap a few years ago, who had bouts
of central abdo pain, moving to RIF, with pyrexia and
a bit of vomiting. Had been admitted a couple of times for
observation, and everything settled sponataneously.
He was so used to this occurring every 6 months or so,
that he no longer bothered consulting doctor for each
episode of pain.
Then, he had another episodes, exactly the same pattern,
but getting worse instead of better after 24 hours.
He walked into evening surgery with an acute, rigid abdo,
diagnosis of peritionitis made, admitted, and on laparotomy
was found to have a ruptured appendix.
</Anecdote warning!!>
--
Ruth
http://www.stamford.co.uk/littlesurgery
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