Autoamputation of appendix and the 'absent' appendix.

To the Editor .—Autoamputation should be added as another possible reason for the "absent" appendix to those that were listed by Rolff et al 1 in the August 1992 issue of theArchives.An autoamputated appendix is often not easily found during exploration for suspected acute appendicitis. The surgeon is then tempted to accept that the appendix is absent. During a period of 30 years (1961 to 1991), five cases of autoamputated appendix were treated in our department. In every case the possibility of absent appendix was considered before the exact nature of the anatomopathologic situation was recognized. The autoamputated appendix can remain an inflammatory focus. 2 However, it is obvious from the operative and histologic findings that, in the case reported by Rolff et al, the symptoms were not related to the fibrotic stringlike structure found at operation.