Histopathological spectrum of appendicectomy specimens - A prospective study

• Author Details:   
• R. Sujatha
• Anushree CN
• Neha Singh

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Introduction: Acute appendicitis accounts for one of the most common conditions that demands emergency surgery. It is a clinical entity with an ongoing diagnostic challenge. Grossly, normal-appearing appendix, removed from patients with suspected acute appendicitis, on histopathological examination may reveal a more serious underlying pathology. Hence, histopathological studies form the gold standard for diagnosis of acute appendicitis. Faecoliths are the usual cause of obstruction, though there are many other causes, ranging from inflammatory conditions to malignancies.
Aim: To study histopathological patterns in all the patients who underwent appendectomy at our institution for a duration of 18 months, and to correlate with the clinical diagnosis.
Materials and Method: This is a prospective study of 230 appendicectomies carried out at Dr. B.R. Ambedkar Medical College and Hospital during a period of 18 months from April 2015 to October 2016. Clinical data was collected from patients of corresponding appendicectomy specimens received in histopathology department of Dr. B.R. Ambedkar Medical College and were processed routinely. Sections obtained were studied to determine various histopathological patterns in appendicectomy specimens.
Results: A total of 230 specimens were analyzed. 139(60.4%) were males and 91(39.6%) were females. The histopathological examination showed Acute appendicitis (46.5%), Chronic/recurrent appendicitis (27.8%), Acute suppurative appendicitis (6.5%), Eosinophilic appendicitis (3.5%), Gangrenous appendicitis (2.2%), Perforated appendicitis (1.3%), Carcinoid tumor (1.3%), Parasitic infestation (1.3%), Mucinous cystadenoma (0.4%). Negative appendiectomy rate was found to be 9.2%.
Conclusion: Most of the cases in this study were diagnosed with usual features of appendicitis, though a few of them were essential incidental diagnoses which were missed preoperatively or intraoperatively. These important incidental diagnoses undeniably support the notion that all appendectomy specimens should be sent routinely for histopathological examination, which is not followed in many hospitals in India.

Keywords: Appendicectomy, Histopathology, Appendicitis, Cystadenoma