Appendicular pseudodiverticula and acute appendicitis: Our 12-year experience

Manzanares-Campillo, María del Carmen; Pardo-García, Ricardo; Martín-Fernández, Jesús

doi:10.4321/s1130-01082011001100005

Cited by 14 publications

(16 citation statements)

References 13 publications

(27 reference statements)

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“…1,10 Appendiceal diverticula are very rare, and the reported incidence in appendectomy specimens has ranged from 0.004% to 2.1%. 9,20 Diverticula may occur singly or multiply, but are usually smaller than 0.5 cm and located within the distal third of the appendix on the mesenteric side. The etiologies of diverticula are congenital or acquired.…”

Section: 2324mentioning

confidence: 99%

“…Appendicular diverticulosis is usually asymptomatic, but the most common complications (perforation and inflammation) can cause abdominal pain that mimics acute appendicitis. 9,20 In the current study, we sought to determine the occurrence and type of unusual factors in acute appendicitis cases or in cases that mimicked the clinical presentation of acute appendicitis. The findings are expected to help answer two key questions related to clinical management of these cases.…”

Section: 2324mentioning

confidence: 99%

“…Finally, ischemia develops in the appendiceal wall, which weakens the epithelial integrity and increases the organ's risk of bacterial invasion. Although lymphoid hyperplasia and fecaliths are the most common causative factors of luminal obstruction, other less frequent factors have been associated with the condition, including enterobiasis, 1 endometriosis, 1,16,21 tuberculosis, 1 amebiasis, 1 actinomycosis, 1 adenovirus, 4 granulomatous diseases, 1,7,15,19 eosinophilic granuloma, 8 neurogenic appendicopathy, 11,12 foreign body melanosis, 4 neurofibroma, 4 diverticulitis, 1,9,20 and taeniasis, 1,17,21 as well as appendiceal malignancies, such as carcinoid tumor, 1,13,14 gastrointestinal stromal tumor, 1 hyperplastic polyp, 1 tubular adenoma, 1 villous adenoma, 1 mucocele, 10 mucinous cystadenoma, 1 adenocarcinoma, 1 mucinous cystadenocarcinoma, 1 lymphoma, 1 and leukemia. 1 This study was designed to investigate the occurrence and distribution of unusual pathologic findings encountered in appendectomy specimens of patients who had undergone surgery to treat an initial diagnosis of acute appendicitis.…”

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confidence: 99%

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Routine Histopathologic Examination of Appendectomy Specimens: Retrospective Analysis of 1255 Patients

Emre

Akbulut

Bozdağ

et al. 2013

International Surgery

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The objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17-85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis. Ninety-four percent of the appendectomy specimens were positive for appendicitis. Of those, 880 were phlegmonous appendicitis, 148 were gangrenous appendicitis with perforation, and the remaining 88 showed unusual histopathologic findings. In the 88 specimens with unusual pathology, fibrous obliteration was observed in 57 specimens, carcinoid tumor in 11, Encheliophis vermicularis parasite infection in 8, granulatomous inflammation in 6, appendiceal endometriosis in 2, and 1 specimen each showed mucocele, eosinophilic infiltration, Taenia saginata parasite infection, and appendicular diverticulitis. All carcinoid tumors were located in the distal appendix. Six of the 11 carcinoid tumors were defined by histopathology as involving tubular cells, and the other 5 as involving enterochromaffin cells. Six patients had muscularis propria invasion, 2 patients had submucosa invasion, 2 patients had mesoappendix invasion, and 1 patient had serosal

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Section: 2324mentioning

confidence: 99%

Section: 2324mentioning

confidence: 99%

mentioning

confidence: 99%

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Routine Histopathologic Examination of Appendectomy Specimens: Retrospective Analysis of 1255 Patients

Emre

Akbulut

Bozdağ

et al. 2013

International Surgery

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“…29,30 The most widely accepted theory is abnormal bowel re-permeabilization during the intestine's solid phase. 31 DA has been associated with 13-15 trisomy syndrome and pancreatic cystic fibrosis. 24,30 Far more common is the acquired form (prevalence rate of 0.65%-2.0%), which is usually due to obstruction, including that caused by neoplasia.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis of the association between diverticulosis of the appendix and neoplasia

Lim

Cheah

Kwok

et al. 2020

ANZ Journal of Surgery

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Background: Diverticula of the appendix (DA) are infrequent and their clinical implications are often overlooked. Several studies have found a significantly increased prevalence of neoplasms in appendiceal specimens with diverticula. Despite the potential clinical implications, there is a paucity of literature. A systematic review and meta-analysis was performed to evaluate the prevalence of DA and its association with neoplasia. Methods: A systematic search of literature (Cochrane, EMBASE, PubMed and Medline) reporting the prevalence of DA and association with neoplasia was performed in November 2019. Relevant articles were assessed in accordance with the PRISMA guidelines. Risk of bias assessment was carried out using modified Newcastle-Ottawa scale. Meta-analysis with risk ratio and random-effects model was performed using RevMan. Results: The initial search identified 1122 potential articles of which 11 were appropriate for quantitative analysis. The prevalence rate of DA was 1.74%. The mean age of patients with DA and those without DA was 41.2 and 33.9 years, respectively. The ratio of male to female was 1.8:1. The prevalence of neoplasia in specimens without DA versus those with DA was 1.28% and 26.94%, respectively. Only four studies addressed the prevalence of locoregional neoplasia in the setting of DA compared to control. Meta-analysis with random-effects model demonstrated that pooled risk ratio was 25.46 (95% confidence interval 12.77-50.75, P < 0.00001). Conclusion: The strong association with neoplasia in this meta-analysis reinforces the clinical significance of DA. Surgeons, pathologists and radiologists should be mindful of this uncommon pathology and consider individualized patient management, until further evidence can direct clinical guidelines for the management of patients with DA. We conducted a systematic review and meta-analysis of the available literature to evaluate the current evidence on DA prevalence and its association with neoplasia. To our knowledge, this is the first meta-analysis to examine this association. A significant positive association would suggest that the discovery of DA may warrant further investigations to guide appropriate patient management. Methods Literature search strategy

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“…Diverticular disease is normally associated with the left colon especially the sigmoid but incidences of appendix diverticulum have been reported [34][35][36][37]. As with diverticulum in other areas they can become inflamed and present in a similar fashion to appendicitis.…”

Section: Appendix Diverticulummentioning

confidence: 99%

Appendicectomy: A Simple Trainee Procedure?

L¹

2015

Emerg Med (Los Angel)

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Appendicular pseudodiverticula and acute appendicitis: Our 12-year experience

Cited by 14 publications

References 13 publications

Routine Histopathologic Examination of Appendectomy Specimens: Retrospective Analysis of 1255 Patients

Routine Histopathologic Examination of Appendectomy Specimens: Retrospective Analysis of 1255 Patients

Systematic review and meta‐analysis of the association between diverticulosis of the appendix and neoplasia

Appendicectomy: A Simple Trainee Procedure?

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