Intestinal obstruction after appendectomy

Background: The frequency of intestinal obstruction varies in the literature (0.2-10.7%) and requires evaluation in a proper design. Methods: From 1978 to 1985, 1951 patients underwent appendectomy; 58 patients were excluded because of appendectomy per occasionem, 156 because of previous laparotomy, and 190 because of simultaneous major surgery. Three foreigners were lost to follow-up. The cohort was linked to the Danish National Inpatient Register for identification of cases, defined by intestinal obstruction requiring surgical intervention. Results: The follow-up period was long (median, 3563 days; range, 2-5113). Twenty-one patients developed intestinal obstruction. The cumulated incidence was 0.33% after 30 days, 0.79% after 1 year, and 1.51% after 14 years. Female sex as compared with male sex (RR= 3.91; 95% confidence limits (CL), 1.28-12.0) and removal of a normal appendix as compared with an inflamed appendix (RR=4.0; 95% CL, 1.28- 12.5) carded a significantly higher risk of intestinal obstruction. Conclusion: Intestinal obstruction after open appendectomy is rare.