Unusual Findings in Appendectomy Specimens of Adults: Retrospective Analyses of 1466 Patients and a Review of Literature

Abstract

Background:Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis.Objectives:This retrospective study was conducted to document the unusual findings in appendectomy specimens.Patients and Methods:Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88 %) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients’ age, gender, clinical presentations, operative reports, pathological reports and follow up.Results:Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34 ± 19. Twenty-nine patients (50.8 %) were male and 28 (49.2 %) were female. Normal appendix tissues were observed in specimens of 26 (45.6 %) patients and inflamed appendix in 31 (54.3 %). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology.Conclusions:Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.

Is Enterobius vermicularis infestation associated with acute appendicitis?

“…The incidence of E. vermicularis in specimens of patients who underwent appendectomy due to acute appendicitis was 0.62 % in our study, which correlates well with the recent incidence studies from Turkey [1,5,6]. Previous reports have shown that the incidence is between 0.35 and 12.5 % in different parts of the world [5][6][7][8][9][10][11].…”

“…Previous reports have shown that the incidence is between 0.35 and 12.5 % in different parts of the world [5][6][7][8][9][10][11]. This result should be kept in mind by surgeons when making a differential diagnosis of acute appendicitis in an endemic area.…”

Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

“…The histopathological diagnosis of appendiceal endometriosis is based on the demonstration of endometrial tissue in the specimen. This condition is often treated with surgery and hormone therapy [2,3,14]. In our current study, appendiceal endometriosis was detected in one patient.…”

“…At the end of the nineteenth century, it was first shown that the localization of E. vermicularis on the appendiceal lumen causes appendicitis. Previous studies have shown that the incidence of E. vermicularis is between 0.6 and 3.8 % in surgical specimens of patients suspected to have appendicitis [14]. These patients should also undergo anthelmintic treatment, as appendectomy only treats the consequences, but not the cause, of disease.…”

Acute Appendicitis and Periappendicitis Revealing Squamous and Transitional Cystic and Solid Nests in Adult Patients: Metaplasia or Vestigeal Remnants?

“…[1][2][3] More recently, in the 4 large reported series of appendectomies, one case of squamous metaplasia is mentioned. [4][5][6][7] Few data are available on the clinical contexts.…”