Asociación entre amigdalectomía, adenoidectomía y apendicitis / Association between tonsillectomy, adenoidectomy, and appendicitis

RESUMEN

Introduction: tonsillectomy, with or without adenoidectomy,is one of the most frequent surgical procedures generally performed,especially in young patients. Several studies suggest thatthere is a relationship between tonsillectomy and altered MALTimmune system.Objective: to examine the possible association between tonsillectomyor adenoidectomy and the risk of subsequent appendicitis.Material and method: a cross-sectional study was performedin 650 patients admitted to the emergency department of a generalhospital in Valencia, Spain. Previous history of tonsillectomyand/or adenoidectomy was related to a history of appendectomy.A descriptive study and an analysis of the relationship betweenprevious operations and appendicitis was performed. A multivariableanalysis controlled for age and sex was also performed, includingthe possible interaction of the gender variable. The independenteffect of each of the procedures (tonsillectomy,adenoidectomy) was tested.Results: the 25.5% of patients had undergone tonsillectomyand 11.5% adenoidectomy; 17.5% had had an appendectomy.On average, women were operated on more frequently than men.In the bivariate analysis, both tonsillectomy and adenoidectomywere significantly associated with subsequent appendectomy. Inthe multivariate analysis, this association was only maintained fortonsillectomy (OR: 3.23; 95% CI: 2.11-4.94). A stratified analysiscontrolling for sex showed a modification of this effect, with ahigher association in women (OR: 5.20; 95% CI: 2.91-9.28) thanin men (OR: 1.74; 95% CI: 0.90-3.39).Conclusions: a clear association has been found, especially inwomen, between previous tonsillectomy and subsequent acute appendicitis.Due to a lack of data on acute appendicitis there shouldbe further studies to explain the findings of this study, as this couldbe the first described risk factor of acute appendicitis