Yale SH, Tekiner H, Yale ES. Recurrent and chronic appendicitis: Diagnostic challenges and clinical insights. World J Gastrointest Surg 2025; 17(11): 111404 [DOI: 10.4240/wjgs.v17.i11.111404]
Corresponding Author of This Article
Steven H Yale, MD, Full Professor, Department of Internal Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL 32827, United States. steven.yale.md@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2025; 17(11): 111404 Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.111404
Recurrent and chronic appendicitis: Diagnostic challenges and clinical insights
Steven H Yale, Halil Tekiner, Eileen S Yale
Steven H Yale, Department of Internal Medicine, University of Central Florida, Orlando, FL 32827, United States
Halil Tekiner, Department of the History of Medicine and Ethics, Erciyes University School of Medicine, Melikgazi 38039, Kayseri, Türkiye
Eileen S Yale, Department of Medicine, NSU Medical School, Fort Lauderdale, FL 33328, United States
Author contributions: Yale SH, Tekiner H, and Yale ES were involved in conceptualizing, drafting, and revising of the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Steven H Yale, MD, Full Professor, Department of Internal Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL 32827, United States. steven.yale.md@gmail.com
Received: June 30, 2025 Revised: July 22, 2025 Accepted: September 4, 2025 Published online: November 27, 2025 Processing time: 149 Days and 15.6 Hours
Abstract
Chronic and acute recurrent appendicitis are often underrecognized in clinical practice, particularly in patients presenting with persistent or recurrent right lower quadrant abdominal pain. It is essential to obtain a detailed and comprehensive history from the patient, as careful questioning often reveals a history of prior attacks. Diagnosing recurrent and chronic appendicitis remains challenging, necessitating thorough history-taking, awareness of varied clinical presentations, and physical examination integrating specific maneuvers. Maintaining a high index of clinical suspicion is essential for recognizing these atypical presentations. Confirming a high pretest probability prior to surgical intervention is crucial to avoid unnecessary procedures.
Core Tip: Diagnosing recurrent and chronic appendicitis poses significant clinical challenges. It requires a clear understanding of pathophysiological mechanisms, precise case definitions, and detailed patient history and physical examination. Employing these approaches, supplemented by imaging studies, enhances diagnostic accuracy. Surgeons should avoid operating without a definitive diagnosis to prevent unnecessary interventions.
