Type of publication:
*Chakrabarty A.; *Vardhrajan V.; *Cheetham M
British Journal of Surgery; Sep 2019; vol. 106 S5; p. 70
Aim: In the United Kingdom 1 in 13 people are affected by appendicitis. The commonest age group is between
10 to 20 years. Appendicitis is relatively uncommon in adults over 50 years. There is a belief that appendicitis
may be precipitated or mimicked by colorectal cancer and hence some surgeons recommend that patients over the age of 50 should undergo a post-operative colonoscopy.
Method(s): We identified patients over the age of 50 years who had appendicectomies in our hospital between
2013 and 2017 usingHES data. Detailed data was collected for all the patients from radiology and endoscopy
data bases. We calculated the cost of post-operative colonoscopy to the health system using PBR tariff.
Result(s): 396 patients aged over 50 underwent emergency appendicectomy during the study period. Of these
284 (72%) had had pre-operative C T scans. 88 (22%) out of the 396 patients underwent a colonoscopy within 3 months of their appendicectomy. Of these 88 patients, 62 had pre-operative CT scans. No cancers were found on post-operative colonoscopy. The cost of performing post-operative colonoscopy in this cohort was 35, 464.
Conclusion(s): In an era of liberal preoperative CT scanning for patients over 50 with right iliac fossa pain, it is
not necessary to perform a colonoscopy after appendicectomy. We recommend that for patients who have a
preoperative CT scan, a post-operative colonoscopy is only needed if there are specific imaging abnormalities.
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