Results of Routine Histopathological Examination of Appendectomy Specimens : A Single-center Retrospective Cohort Study

Abstract

Background: Worldwide, one of the most common abdominal emergencies is appendicitis. Routine histopathological examination of appendectomy samples is not at all questioned. Aim of the study: Is to identify the results of the routine histopathological examinations of appendectomy specimens and to correlate them with the preoperative imaging tools. Subjects and methods: In a single secondary health care hospital, a retrospective analysis of 365 appendectomies, for patients operated initially for acute appendicitis, was carried out between April 2020 till April 2023. Demographic, imaging and histopathologic data were retrieved from the patients’ medical records. Results: Out of the studied patients, 95.3% were aged between 12-50 years. One third of the cases was females (32.1%). Laparoscopic appendectomy was operated for the majority of them (77%). Leukocytosis was significantly more frequent between those with positive appendicitis histopathologically. Positive appendicitis was reported between 96.4% of the histopathology reports. The most prevalent diagnosis was acute appendicitis, suppurative appendicitis, gangrenous appendicitis and perforation (50.7%, 41.6%, 2.5% and 1.6%; respectively). Negative appendectomy rate was 3.6%. In diagnosing acute appendicitis, Ultrasound (US) imaging had 66.7% accuracy rate while Computerized Tomography (CT) had a rate of 96.9%. Conclusion: It is evident that although histopathological examination is beneficial in acute appendicitis diagnosis, it advantageous in recognizing the unusual pathological findings. Negative appendectomy rate can be reduced by the use of modern diagnostic modalities, CT is advisable.

Keywords

• acute appendicitis
• routine histopathology examination
• radiological imaging