Appendicitis- Histology Specific Incidence Trends In A Semi Urban Population In New Delhi: A Study Of 262 Cases

Abstract

Objectives: Acute appendicitis is a condition characterized by inflammation of the appendix for which timely surgery is mandatory to prevent morbidity and mortality. The aim of this study was to assess the differences in incidences, age, sex and seasonal variations and to review the histological diagnoses of all the appendicectomy samples.Methods: A retrospective analysis of patients who underwent appendicectomy at the Hakeem Abdul Hameed Centenary Hospital, New Delhi during the period Jan 2007 to Oct 2010.All the relevant data were retrieved from the accompanying laboratory request forms or patients files records where available. All histology slides were also retrieved and reviewed. To overcome the lack of standardization which is inherent in a retrospective analyses of this type, on review, all the cases were grouped into histopathologic categories Results: Of the 262 cases reviewed, acute suppurative appendicitis accounted for the maximum cases(80,30.53%) and a negative appendicectomy rate of 7% was observed. Male predominance was seen with a M:F ratio of 1.4:1.A peak incidence of 35.1% was observed in the 21-30years age group. A seasonal trend of majority cases being confined to the months of June -August coinciding with the rainy season was noted. Conclusion: The vermiform appendix is a vestigial organ with no specific function. It comes into the limelight when a diagnosis of acute appendicitis is made by the surgeon based upon clinical features and physical examination. Histological examination of the appendix is therefore necessary to assess the surgeon's rate of negative appendicectomy as well as avoid missing a rare diagnosis or a malignancy. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11722 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12

Histopathologic Distribution of Appendicitis at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, in 2012

“…3,19 Timely surgery is mandatory to prevent this outcome. 15 Perforation rate observed in this study was considerably high compared to the other studies which ranged from 0.8% to 20%. 3-5, 10,11 However, a significant perforation rate (34%) was also found by Chamisa et al 2 Considering the age group, perforated appendicitis peaked in the 0 to 9 years group in our study as shown by Sulu et al 3 Besides in the early ages, the literature also stated that perforation is prevalent in the elderly group.…”

“…It shows extensive mucosal ulceration and hemorrhage necrosis of all layers under the microscope. 4,15 This grouping of acute appendicitis, however, was not applied in our study site at the time of this study was conducted. The histopathologic type of appendicitis was defined as acute and chronic only.…”

“…Based on the pathologic stages, acute appendicitis can be further divided into early acute, acute suppurative, acute gangrenous, and perforative. 4,6,15 Early acute appendicitis is macroscopically defined by dull serosal surface of appendix. Microscopically, it shows perivascular and mild to moderate transmural neutrophil infiltration.…”