Recurrent acute appendicitis

Appendicitis is notoriously recurrent. It is not uncommon for patients to attribute such attacks to ‘biliousness’ or dyspepsia. The attacks vary in intensity, may occur every few months and the majority of cases ultimately culminate in severe acute appendicitis. If a careful history is taken from patients with acute appendicitis many remember having had milder but similar attacks of pain. The appendix in these cases shows fibrosis indicative of previous inflammation (Fig. 59.20). Chronic appendicitis, per se, does not exist. Patients labelled thus are usually examples of the recurrent form of the disease.