THE MENSTRUAL-CYCLE AND ACUTE APPENDICITIS

Objective: To examine the influence of the menstrual cycle on the inci dence and presentation of acute appendicitis. Design: Retrospective st udy. Setting: University hospital, Israel. Subjects: 144 women of chil d bearing age operated on for suspected acute appendicitis and subdivi ded according to the menstrual phase during which they presented. Main outcome measures: The final diagnoses, clinical presentation, and lab oratory data. Results: There were no significant differences in the in cidence of acute, gangrenous, or perforated appendicitis in patients o perated on during the various phases of the menstrual cycle. During me nstruation, however, a normal appendix not accompanied by other diseas e was found significantly more often (p = 0.04). Clinical presentation , physical findings, and laboratory results did not vary throughout th e menstrual cycle except for the ''classic shifting pain'' which was s ignificantly more common during the luteal phase. Conclusions: Acute a ppendicitis occurs randomly during the various phases of the menstrual cycle. The incidence of operations for uninflamed appendixes may be h igher during the menstrual phase. Significantly more negative laparoto mies are done during the menstrual phase, which suggests the existence of a functional disorder that mimics acute appendicitis.