Appendectomy by Intussusception

Richard M. Marks, MD; Gabriel Halby, MD
Arch Surg. 1972;105(3):532. doi:10.1001/archsurg.1972.04180090127033.
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To the Editor.  —Hallatt1 in gynecologic surgery and Lilly and Randolph2 in pediatric surgery have rekindled interest in the intussusception (inversion) method for performing an appendectomy. There is immediate appeal, for the technique accomplishes "clean" appendectomy as an incidental procedure.We have had a recent experience with a woman who bled from the residual stump one month after hysterectomy to a level of 7 gm/100 ml of hemoglobin. It is evident that although the mesenteric vascular supply to the appendix is interrupted by this technique, the mural vascular plexus is not. Those vessels remaining may be sufficient to produce significant blood loss.The inability, furthermore, to distinguish an inverted or intussuscepted stump from a polypoid cecal lesion on x-ray examination has led to unnecessary exploratory surgery3 when a later clinical problem presents itself, pointing to obscure gastrointestinal blood loss.Also the creation of an intussusceptum as a


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