Histopathological examination of appendicectomy specimens at a district hospital of Saudi Arabia

Abstract

Background and Objective:Appendicectomy for acute appendicitis is one of the most commonly performed surgical procedures. Acute appendicitis has remained a clinical entity and an ongoing diagnostic challenge. A retrospective study was performed to determine histological diagnosis, demographic data, the rate of perforated appendicitis and negative appendicectomies.Methods:Histopathological records of 480 resected appendices submitted to histopathology department at Arar Central Hospital in the Northern Border Province of Saudi Arabia over the period of 3 years from July 2011 to June 2014 were reviewed retrospectively, to determine acute appendicitis, complication (gangrene, perforation) rate, negative appendicectomy rate, histopathological diagnosis and unusual finding on histology.Results:Out of 480 specimens of appendix, appendicitis accounted for 466 (97.0%) with peak occurrence in the age group of 11 to 50 years in male and 11 to 40 years in female. Histopathological diagnosis include acute appendicitis 250 (52.0%), suppurative appendicitis 135 (28.0%) acute gangrenous appendicitis 60 (12.5%), perforated appendicitis 9 (2.0%), chronic appendicitis 12 (2.5%). Negative appendicectomy rate was 14 (3%) and two time more common in female with peak occurrence in the age group of 20-30 yrs. There was no unusual histological finding like carcinoid tumour of appendix.Conclusion:The present study showed a high number of appendicitis in adolescents and young adults. Negative appendectomy was more common in females. The study support routine histological examination of all the appendicectomy specimens to avoid missing of any clinically important and treatable condition.

Should Every Appendecectomy Specimen Be Subjected to Histopathological Examination? A Retrospective Study of Histological Findings in Appendicectomy Specimens

“…10,14 The acceptable negative appendicitis rate is 10-20%. 8 In this study, the histopathological analysis of 155 cases showed acute appendicitis in 45.8%, while in other studies it was similar with 45.6%, 52% and 30.6%. 6,8,12 The next more common cause of appendicitis in our study was recurrent appendicitis in 21.9%.…”

“…8 In this study, the histopathological analysis of 155 cases showed acute appendicitis in 45.8%, while in other studies it was similar with 45.6%, 52% and 30.6%. 6,8,12 The next more common cause of appendicitis in our study was recurrent appendicitis in 21.9%. The incidence of perforated appendicitis in our study was higher 9% compared to others with 1.9%, 2.1% and 2%.…”

“…The incidence of perforated appendicitis in our study was higher 9% compared to others with 1.9%, 2.1% and 2%. 6,7,8 The higher incidence of perforation in our study could be attributable to delayed or missed diagnosis and late referral as all of these cases are from distant rural dwellings. The other histopathological findings were acute suppurative appendicitis, gangrenous appendicitis and acute appendicitis with abscess accounting to 3.2% each.…”

“…7 However, histopathological examination still remains the gold standard for the confirmation of appendicitis. 8 This retrospective study disclosed a spectrum of histopathological lesions in the resected appendicectomy specimens. The incidence of appendicitis was higher in the 2 nd and 3 rd decade with male predominance, which is similar to other studies.…”

“…The incidence of appendicitis was higher in the 2 nd and 3 rd decade with male predominance, which is similar to other studies. 3,6,8 There are very few studies, which evaluates the benefits of analysing the appendicectomy specimens. It is a routine practice at our institution to send all resected appendicectomy specimens for histopathological examination.…”