ELECTIVE LAPAROSCOPIC APPENDECTOMY IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER

Familial Mediterranean fever (FMF) also known as hereditary polyserosi tis, is an inherited disorder commonly found in Armenians, Turks, Arab s, Balkans, and Jews originating from North African countries. The dia gnosis of FMF is based on clinical findings and family history, as no specific diagnostic test is yet available. One of its main clinical fe atures is recurrent acute episodes of peritonitis. During such an epis ode, physical examination and laboratory findings may be similar to th ose for acute appendicitis. Therefore up to two-thirds of FMF patients undergo emergency appendectomy, with the appendix being normal in mos t cases. As laparoscopic appendectomy has proved to be safe and advant ageous, and to prevent misdiagnosis and unnecessary emergency surgery, we performed elective laparoscopic appendectomy in 13 FMF patients ra nging in age from 8 to 32 years. They had been suffering from the dise ase for 1 to 12 years (mean 3.8) and had had an average of 3.5 yearly episodes of FMF peritonitis. All procedures were concluded by laparosc opy without conversion to open surgery. The average postoperative hosp ital stay was 3.07 days. The only complication was superficial wound i nfection in one patient (7.6%), and the mean time to regain full norma l activity was 8.5 days. We conclude that elective laparoscopic append ectomy in FMF patients is safe. It helps to exclude appendicitis as a cause for peritonitis in these patients and may prevent unnecessary em ergency surgery.