Abdominal complaints and appendiceal changes leading to the diagnosis of cystic fibrosis.

Twelve patients with abdominal complaints had an operation that included incidental appendectomy. 
They were later diagnosed as having cystic fibrosis. Four groups of 
presenting signs and symptoms were right lower quadrant mass, chronic abdominal 
pain, intestinal obstruction, and hepatomegaly. In all cases the symptoms precipitating 
operation were due to the underlying unrecognized condition: cystic fibrosis. Review 
of the histology of the appendix revealed the classic changes of 
hypersecretion of the mucous glands to be present. The appendix shares 
in the generalized intestinal mucous gland involvement peculiar to cystic fibrosis. 
Awareness of this fact has not been widespread, perhaps because of 
the usual emphasis on the pulmonary and pancreatic aspects of the 
disease. Greater appreciation of the clinical symptoms of cystic fibrosis and 
more liberal use of the sweat test could have diminished the 
number of exploratory celiotomies. Recognition of the histoloc changes in the 
removed appendices can also suggest the proper diagnosis and lead to 
earlier institution of treatment with an improved prognosis. 