Periappendicitis: Our 13 year experience

Al-Saffar

Annals of Medicine &Amp; Surgery

et al. 2021

Introduction While appendicitis is considered one of most common acute surgical conditions, several studies have reported abnormal histopathological findings in appendectomy specimens; however, sending all appendices to histopathology is not yet routinely done.Here we report many unusual findings. Those unusual findings played a role not only in confirming acute appendicitis as a cause of the presentation in some cases but also discovering etiologies that mimic it with great impact on its management. Methods Between January 2011 and December 2017, a total of 1510 patients were operated with appendectomy for a primary diagnosis of acute appendicitis. Among them, a total of 72 patients had incidental histopathologic findings in association with acute appendicitis or other pathologies instead of acute appendicitis. A retrospective analysis for those 72 patients was performed with all data being retrieved from the electronic health record system. Results Patients ages ranged between 4 and 71 years with a mean age equal to 23.1 years (SD = 14.2). Majority of patients were women (n = 52; 72.2%). Sixty of the seventy-two cases were seen in patients with negative appendectomies (n = 333) with an overall rate of 18% among this group of patients. The remaining 12 patients had additional findings in histopathology specimens beside acute appendicitis (n = 1131) with an overall rate of 1%. The most commonly reported pathologies were serositis, ovarian cysts, and Enterobius vermicularis in descending frequency. Conclusion Identification of unusual histopathological findings during microscopic examination of resected appendices is more common in female patients and in patients with negative appendectomy. histopathologic assessment of specimens will allow detection of congenital, infectious or malignant pathologies that mimic acute appendicitis clinically even in the absence appendicitis microscopically.

Section: Discussionmentioning

confidence: 99%

Unusual histopathological findings in appendectomy specimens with clinical diagnosis of acute appendicitis: A retrospective cohort analysis

Al-Saffar

Annals of Medicine &Amp; Surgery

et al. 2021

“…The most common cause of periappendicitis is salpingitis [6] and has been diagnosed in 5.4 % of female patients with a preoperative diagnosis of acute appendicitis [7]. In this case, pathological findings revealed inflammation on both sides of the appendix.…”

Section: Discussionmentioning

confidence: 74%

Periappendicitis during adalimumab treatment for ileocecal Crohn’s disease in a 29-year-old male

Mizuno

Nakazawa

Ogawa

et al. 2015

Clin J Gastroenterol

A 29-year-old male was diagnosed with ileocolic Crohn's disease (CD) approximately 2 years ago. Adalimumab was prescribed as CD remission induction therapy. Three months after beginning adalimumab, watery diarrhea and lower abdominal pain developed. He was admitted under a diagnosis of CD exacerbation. Despite fasting and antibiotic treatment, symptoms of acute panperitonitis appeared. He was diagnosed as acute appendicitis and we performed emergency surgery for peritoneal drainage and ileocecal resection on the fifth hospital day. We diagnosed periappendicitis based on the operative findings. This is the first report of periappendicitis with CD during adalimumab treatment.

J of Obstet and Gynaecol

“…Most cases were caused by salpingitis while some cases were caused by pelvic inflammatory disease, typhoid enteritis, peritoneal tuberculosis, inflammatory bowel disease, and amoebiasis . Leaving these patients without proper investigation and treatment for primary causes of periappendicitis might cause significant morbidity in the future …”

Section: Discussionmentioning

confidence: 99%

Incidental appendectomy during mini incision post‐partum sterilization (Chokchai technique): A prospective cross‐sectional study

Choksuwattanasakul

2017

When carried out by experienced surgeons and with appropriate anesthesia, incidental appendectomy during PPS is safe. The Chokchai technique (approach through a small periumbilical incision) achieved a high success rate and resulted in minimal scar. Incidental appendectomy not only prevents any future appendicitis but also helps to detect periappendicitis and treat its primary cause. However, this is an option for only selected patients who are clearly informed about the possible risks and benefits of the procedure.