Surgery>>>>>The Appendix
Question 1#

The incidence of appendectomy for acute appendicitis was decreasing in the United Status until the 1990s, at which point the frequency of appendectomy for nonperforated appendicitis began to rise. What is one potential explanation for this observation?

A) Increased use of diagnostic imaging and detection of appendicitis that otherwise would have resolved
B) Increased incidence of obesity and the impact of periappendicular fat on luminal obstruction
C) Increasing incidence of inflammatory bowel disease and the potential mitigation of ulcerative colitis symptoms seen with appendectomy
D) Reimbursement patterns have changed in the United States, favoring aggressive surgical decision making

Correct Answer is A

Comment:

While the true reason is unknown, some have suggested that the quality and usage of diagnostic imaging in the past 20 to 30 years has resulted in the detection of acute appendicitis that would have otherwise spontaneously resolved. While appendectomy may mitigate the clinical symptoms of ulcerative colitis, this is likely not responsible for the broad reduction in observed appendectomy. Obesity is not known to impact appendicitis incidence. Reimbursement patterns should hopefully not impact surgical decision making so directly.