SURVEILLANCE OF APPENDICECTOMY SPECIMEN WITH HISTOMORPHOLOGICAL EVALUATION

Authors

  • Pratima Baisakh Department of Anatomy, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, K8, Kalinga Nagar, Bhubaneswar –751 003, Odisha, India.
  • Manas Ranjan Baisakh Department of Pathology, Apollo Hospitals, Bhubaneswar, Odisha, India.
  • Prafulla Kumar Chinara Department of Anatomy, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, K8, Kalinga Nagar, Bhubaneswar –751 003, Odisha, India.
  • Mahesh Chandra Sahu Directorate of Medical Research, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar – 751 003, Odisha, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i7.25432

Keywords:

Appendicitis, Appendicectomy, Mucocele, Endometriosis

Abstract

Objective: Appendicectomy is the gold standard treatment in acute appendicitis, and in each case, a specimen should be evaluated thoroughly by a histopathologist to confirm the diagnosis and any unknown pathology. The present study aims to find out age and gender prevalence of appendicitis in a tertiary care hospital in Eastern India and various histological changes in the appendix in routine appendicectomy specimen undergoing surgery for appendicitis.

Methods: A total of 780 appendicectomy specimens were studied for acute appendicitis for 2 years. Gender prevalence and age-wise incidence of appendicitis were analyzed statistically. Sections were taken from different parts of formalin-fixed appendix specimen. A thorough histological examination was done to confirm acute appendicitis and to detect any incidental unusual histological changes.

Results: Of 780 cases, 343 (44%) were male and 437 (56%) were female. Females are more in number than males (p<0.001). The incidence was more common in the age group of 21–30 years (50.7%). Histological findings revealed normal vermiform appendix in 60 (7.7%), lymphoid hyperplasia in 75 (9.6%) cases, acute appendicitis and periappendicitis in 471 (60%) and 110 (14%) cases, respectively. Gangrenous appendicitis was found in 56 (7%) cases. Unexpected findings were reported in 8 (1.02%) cases, of which Enterobius vermicularis 2 (0.25%) cases, endometriosis 2 (0.25%) cases, mucocele 1 (0.12%) case, and carcinoid in 3 (0.4%) cases.

Conclusions: Apart from intraoperative examination, a routine histological study of biopsy specimen reveals at times rare pathological changes which has some impact on clinical co-relation and patient management and might help to avoid any lethal complications.

Downloads

Download data is not yet available.

References

Buschard K, Kjaeldfaard A. Investigation and analysis of the position, fixation, length and embryology of the vermiform appendix. Acta Chir Scand 1973;139:293-8.

Guidry SP, Poole GV. The anatomy of appendicitis. Am Surg 1994;60:68-71.

O’Connell PR. The vermiform appendix. In: Williams NS, Bulstrode CJ, O’Connell PR, editors. Bailey and Love’s Short Practice of Surgery. 25th ed. London (UK): Hodder Arnold; 2008. p. 1204-18.

Baigrie RJ, Dehn TC, Fowler SM, Dunn DC. Analysis of 8651 appendicectomies in England and Wales during 1992. Br J Surg 1995;82:933.

Hale DA, Jaques DP, Molloy M, Pearl RH, Schutt DC, d’Avis JC. Appendectomy: Improving care through quality improvement. ArchSurg 1997;132:153-7.

Matthyssens LE, Ziol M, Barrat C, Champault GG. Routine surgical pathology in general surgery. Br J Surg 2006;93:362-8.

Duzgun AP, Moran M, Uzun S, Ozmen M, Ozer VM, Seckin S, et al. Unusual findings in appendicectomy specimens: Evaluation of 2458 cases and review of the literature. Indian J Surg 2004;66:221-6.

Nemeth L, Reen DJ, O’Briain D, McDermott M, Pui P. Evidence of an inflammatory pathologic condition in Normal†appendices following emergency appendectomy. Arch Path Lab Med 2001;125:759-64.

Modlin IM, Sandor A. An analysis of 8305 cases of carcinoid tumours. Cancer 1997;79:813-29.

Connor SJ, Hanna GB, Frizell FA. Appendiceal tumors. Dis Colon Rectum 1998;41:75-80.

Birnbaum BA, Wilson SR. Appendicitis at the millennium. Radiology 2000;215:337-348.

Vishram S. Clinical and Surgical Anatomy. 2nd ed. New Delhi: Elsevier; 2007. p. 178-9.

Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910-25.

Primatesta P, Goldacre MJ. Appendicectomy for acute appendicitis and for other conditions: An epidemiological study. Int J Epidemiol 1994;23:155-60.

Naveen K, Sareesh NN, Satheesha BN, Murlimanju BV, Suhani S, Mamatha H, et al. Appendicitis and appendectomy: A retrospective survey in south Indian population. J Surg Acad 2013;3:10-3.

Noudeh YJ, Sadigh N, Ahmadnia AY. Epidemiologic features, seasonal variations and false positive rate of acute appendicitis in Shahr-e-Rey, Tehran. Int J Surg 2007;5:95-8.

Al-Omran M, Mamdani M, McLeod RS. Epidemiologic features of acute appendicitis in Ontario, Canada. Can J Surg 2003;46:263-8.

Bobekir AR, Devi N. Analysis of pathology of 405 appendectomies. East Afr Med J 1990;67:599-602.

Akbulut S, Tas M, Sogutcu N, Arikanoglu Z, Basbug M, Ulku A, et al. Unusual histopathological findings in appendectomy specimens: A retrospective analysis and literature review. World J Gastroenterol 2011;17:1961-70.

Jones AE, Phillips AW, Jarvis JR, Sargen K. The value of routine histopathological examination of appendicectomy specimens. BMC Surg 2007;7:17.

Gustofson RL, Kim N, Liu S, Stratton P. Endometriosis and the appendix: A case series and comprehensive review of the literature. Fertil Steril 2006;86:298-303.

Stenchever MA, Droegemueller W, Herbst AL. Comprehensive Gynecology. 4th ed. St. Louis: Mosby; 2001.

Nagapuri S. Market research on usage of antibiotics in serious infections. Int J Pharm Pharm Sci 2014;6:371-4.

Sodimbaku V, Pujari L. Urolithiasis-an updated review over genetics, pathophysiology and its clinical management. Int J Pharm Pharm Sci 2014;6:23-31.

Published

07-07-2018

How to Cite

Baisakh, P., M. R. Baisakh, P. K. Chinara, and M. C. Sahu. “SURVEILLANCE OF APPENDICECTOMY SPECIMEN WITH HISTOMORPHOLOGICAL EVALUATION”. Asian Journal of Pharmaceutical and Clinical Research, vol. 11, no. 7, July 2018, pp. 117-9, doi:10.22159/ajpcr.2018.v11i7.25432.

Issue

Section

Original Article(s)

Most read articles by the same author(s)

<< < 1 2