Impact of routine histopathological examination of appendectomy specimens on patient management: a study of 4012 appendectomy specimens

Elfaedy, Osama; Benkhadoura, Mohamed; Elshaikhy, Akrem; Elgazwi, Khaled

doi:10.5578/turkjsurg.4253

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…Patel and Shah in 2017 recorded 5% unusual findings 9 and Dincel et al in 2018 reported 3% unusual findings in the routinely examined appendectomy specimens 4 . Elfaedy et al (in 2019) 19 recorded 256 out of 4012 (6.2%) unusual findings but they counted the chronic appendicitis finding as an unusual, in our study we did not find any case of chronic appendicitis.…”

Section: Discussioncontrasting

confidence: 51%

The Utility of Routine Histopathological Examination of the Appendectomy Specimens

Hasan¹,

Nafie²,

Abbadi³

et al. 2020

Ann of Pathol and Lab Med

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Background: Appendectomy is the most commonly performed surgical procedure worldwide to manage appendicitis. The practice of sending all appendices specimens for routine histopathology examination depends on the concerned clinician. This study was performed to reveal the importance of routine histopathology examination of the appendectomy specimens with recording of the occurrence and distribution of unusual pathologic findings Methods: This was a retrospective record based comparative study performed in a single Hospital in Saudi Arabia, where the medical files of 766 patients were recruited. The appendectomy specimens were obtained either from our hospital or referred from any other hospital for histopathology examination. All the unusual diagnoses were reviewed by the histopathology author and blindly re-evaluated by other pathology consultant. Statistic analysis was performed manually. Result: 700 cases were within the usual histopathology scope. Unusual histopathological findings were observed in 66 cases (8.6%): four cases of mucinous neoplasms, 20 cases of fibrous obliteration or appendiceal neuroma, 18 cases showed parasitic infestation, and 24 cases were periappendicitis without appendicular acute inflammation. Conclusion: Routine histopathology examination of the appendix not only confirms the clinical diagnosis of acute appendicitis, but also leads to the incidental diagnosis of much unusual pathologies which could have been missed by the surgeon, and these pathologies include parasitic infestation, peri-appendicitis, neuromas and appendiceal mucinous neoplasms.

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Section: Discussioncontrasting

confidence: 51%

The Utility of Routine Histopathological Examination of the Appendectomy Specimens

Hasan¹,

Nafie²,

Abbadi³

et al. 2020

Ann of Pathol and Lab Med

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“…While the rate of acute appendicitis is higher in men, women are more likely to undergo a negative appendectomy (3). The difficulty of differential diagnosis of acute appendicitis in women may be associated with the high rate of negative appendectomy (3,6). In our study, the rate of negative appendectomy was significantly higher in women (70,6%) (p <0.05).…”

Section: Discussionmentioning

confidence: 43%

“…A cute appendicitis is the most common abdominal emergency encountered in general surgery services worldwide (1,2). The overall lifetime risk of this disease is approximately 7% (8.6% in men and 6.7% in women) (3,4). Luminal obstruction is the most common etiology of acute appendicitis (5).…”

mentioning

confidence: 99%

Usual and Unusual Pathologies of Appendicitis: A Retrospective Analysis of 385 Patients

Yardımcı¹,

Uras²

2021

Acibadem Universitesi Saglik Bilimleri Dergisi

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Purpose: Appendectomy is the most common abdominal surgery performed worldwide. In this report, we evaluated the results of pathological examinations of acute appendicitis specimens. Methods:We performed a retrospective analysis of patients operated on for acute appendicitis at our surgical department from 2009 to 2017. Data on age, gender, and pathological diagnostic parameters were analyzed.Results: A total of 385 patients (168 women [43.6%] and 217 men [56.4%]), were classified into acute appendicitis (Group 1), normal appendix (Group 2), and unusual pathological findings (Group 3) groups. The patients undergoing appendectomy were mostly in the 21-30 (n = 136, 35.3%) and 31-40 years (n = 118, 30.6%) age groups. The negative appendectomy rate was 4.4% in Group 2, and the proportion of women (70.6%) was significantly higher in that group than the other groups (p <0.05). In total, 24 (6.2%) patients had unexpected findings. Among the appendix tumors (n = 12 [3.1%]) in our series, low-grade mucinous neoplasm (n = 6, 1.6%) was the most common, followed by a welldifferentiated neuroendocrine tumor (n = 3, 0.8%). Conclusion:Although unusual pathological findings are rare during appendectomy, all appendectomy specimens should be sent for routine histopathological examination. The abnormal incidental findings of 24 cases in this series had a significant impact on management. Patients with rare abnormalities should be treated according to the results of their pathological reports.

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“…It is related to the nature of the children's appendix, where the amount of lymphoid in the appendix is considerable until the age of adolescence and the body's immune system in children prone to disease. Inflammation of the appendix causes enlarging lymphoid organs (12,14,15). 82.7% of sensitivity shows that the ability of ultrasound in diagnosing acute suspected Appendicitis in patients is good.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of the Sensitivity and Specificity of Ultrasound Examination in Patients With Suspected Acute Appendicitis

Majdawati¹,

Sarı²

2021

Advances in Health Sciences Research

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Background: Acute Appendicitis is inflammation of the appendix, which manifests as pain in the lower right abdomen that can develop into an acute abdomen. This situation can end in the emergency room and require immediate surgical treatment. Ultrasound is the initial choice most often used for the diagnosis of Appendicitis as well as determining whether surgery is needed. Objective: To identify the sensitivity and specificity of ultrasound as an imaging modality for the diagnosis of Acute Appendicitis at PKU Muhammadiyah Gamping Hospital in Yogyakarta. The results of this diagnostic test are essential to be used as an evaluation of the radiology skills, the ultrasound modalities used in health services, as well as being useful for improvement. Method: This research study is a diagnostic test of ultrasound of suspected Acute Appendicitis with a gold standard. The result emerged from the histopathological tissue from the appendectomy. The research subjects consisted of 72 suspected Appendicitis subjected to ultrasound and continued with appendectomy and histopathological in 2014 -2017. The sensitivity and specificity values of the ultrasound were calculated, which were useful for evaluating diagnostic services at PKU Muhammadiyah Gamping Hospital, Yogyakarta. Results: The number of study subjects was 72, with positive ultrasound results of 52 and a negative ultrasound of 20 samples. The 52 respondents with positive ultrasound consisted of 25 adults and 47 children dominated by males. Twenty samples with negative ultrasound results consisted of 9 adults and 11 children dominated by females. The results of sensitivity and specificity values of ultrasound were 82.7%, 33.33%, and 53% of accuracy. The results of this value can be used as an evaluation of ultrasound in cases of Acute Appendicitis in PKU Muhammadiyah Gamping, Hospital, Yogyakarta in Indonesia. Conclusion: Ultrasound has a good sensitivity value for the diagnosis of Acute Appendicitis. However, it has a low specificity value. It shows that the ultrasound can be used as a modality for diagnosing Acute Appendicitis, which has a role in screening the diagnosis. Ultrasound cannot be used as a screening for suspected patients with Acute Appendicitis who are entirely normal or in good condition. It will be the researchers' evaluation of the cause of the low specificity value to improve the diagnosis of suspected Appendicitis.

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Impact of routine histopathological examination of appendectomy specimens on patient management: a study of 4012 appendectomy specimens

Cited by 8 publications

References 20 publications

The Utility of Routine Histopathological Examination of the Appendectomy Specimens

The Utility of Routine Histopathological Examination of the Appendectomy Specimens

Usual and Unusual Pathologies of Appendicitis: A Retrospective Analysis of 385 Patients

The Evaluation of the Sensitivity and Specificity of Ultrasound Examination in Patients With Suspected Acute Appendicitis

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