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A Journal on Surgery

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Chirurgia 2001 April;14(2):77-80

language: English

Appendix specimen pathology for presumed acute appendicitis

Pavlidis T., Papaziogas B., Atmatzidis K., Makris J., Lazaridis C., Souparis A., Papaziogas T.


Background. Acute appendicitis is the most common cause of acute abdomen and creates many serious diagnostic problems and surgical difficulties in neglected cases. Primary appendiceal neoplasms and other specific lesions are relatively rare, but important entities that could be manifested as acute appendicitis.
Methods. In our department over the past twenty years a total of 1546 appendectomies for presumed acute appendicitis were carried out in 795 women (51%) and 751 men (49%) with mean age of 51 years (range 15 to 87 yrs).
Results. The operative findings in addition to the histopathology study reports of the removed specimen showed negative results for inflammation in 301 cases (19.5%), serous inflammation in 572 cases (37%), purulent inflammation in 495 cases (32%), necrotic inflammation in 139 cases (9%), appendiceal neoplasm in 31 cases (2%) and rare other pathology in 7 cases (0.45%); in the latter 5 cases of acute diverticulitis, one case of tuberculosis and one case of endometriosis were included. The neoplasm was cystadenoma in 13 cases, cystadenocarcinoma in 9 cases, carcinoid in 7 cases, adenocarcinoid in one case and adenocarcinoma in one case. The initial appendectomy was considered as efficient treatment in 20 cases, but a right hemicolectomy at a second stage was necessary in 11 cases.
Conclusions. Thus, a meticulous histopathologic examination of the removed specimen is required for the detection of any neoplastic lesion and the determination of the definite therapeutic management.

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