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Review of the pathological results of 2660 appendicectomy specimens

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Abstract

Purpose

Appendicitis is the most commonly performed emergency abdominal surgery. The appendix can also be the site of a variety of neoplasms and unusual inflammatory conditions. A retrospective review was performed to determine the pathological diagnoses in appendicectomy specimens.

Methods

This study is a retrospective analysis of 2660 appendicectomies performed from 1997 to 2003. The reports were analyzed for the following parameters: age-related incidence of acute appendicitis, seasonal variation in presentation, perforation rate, rate of negative and incidental appendicectomy, and the incidence of other pathologies encountered.

Results

Of the 2660 appendicectomy specimens, acute appendicitis was seen in 1718 patients (64.58%), with a peak in patients in their second decade (35.09% of cases of acute appendicitis). The perforation rate was 13.9% and was significantly higher in patients aged 70 years or more (P < 0.001). The negative appendicectomy rate was 28.8%, and was significantly higher in female patients (P < 0.001) and in the 11–30 year age group (P < 0.001). Other pathologies include carcinoid (0.52%), adenocarcinoma (0.39%), and mucinous cystadenoma (0.60%).

Conclusions

The high rate of negative appendicectomy among female patients and the increased incidence of perforation in elderly patients reinforce the validity of the judicious use of laparoscopy in these populations. There are still a number of unusual histologies found in appendicectomy specimens supporting the continued use of routine histology.

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Author notes

  1. Ravi Marudanayagam

    Present address: , 80 Hilltop Road, Oldbury, Birmingham, B68 9DY, UK

Authors and Affiliations

  1. Department of General Surgery, University Hospital of Wales, Cardiff, UK

    Ravi Marudanayagam & Brian I Rees

  2. Department of Pathology, University Hospital of Wales, Cardiff, UK

    Geraint T Williams

Authors
  1. Ravi Marudanayagam
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  2. Geraint T Williams
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  3. Brian I Rees
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Marudanayagam, R., Williams, G. & Rees, B. Review of the pathological results of 2660 appendicectomy specimens. J Gastroenterol 41, 745–749 (2006). https://doi.org/10.1007/s00535-006-1855-5

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  • DOI: https://doi.org/10.1007/s00535-006-1855-5

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