Difference between revisions of "Interval appendectomy"

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DDx:
DDx:
*[[Acute appendicitis]] - history is essential to differentiate.
**An interval appendectomy may have active inflammation.<ref name=pmid35076982/>
*[[Negative appendectomy]] - specimen should be [[submitted in toto]], no lymphoid hyperplasia, no chronic inflammation, history is essential.
*[[Negative appendectomy]] - specimen should be [[submitted in toto]], no lymphoid hyperplasia, no chronic inflammation, history is essential.
*[[Adenovirus appendicitis]] - lymphoid hyperplasia.
*[[Adenovirus appendicitis]] - lymphoid hyperplasia.

Revision as of 16:01, 30 November 2023

Interval appendectomy is an appendectomy following the presentation of acute appendicitis.[1]

General

  • Done to exclude neoplasm and recurrent appendicitis.[2]
  • Histologically may mimic Crohn's disease.[3][4]

Microscopic

Features:[4]

  • Muscularis propria eosinophils and/or plasma cells.
  • +/-Fibrosis.
  • +/-Neutrophils in muscularis propria.
  • +/-Muscularis propria neutrophils.
  • +/-Granulatous or xanthogranulomatous inflammation.

DDx:

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Vermiform Appendix, Appendectomy:
	- Benign appendix with mild mixed muscularis inflammation (plasma cells, eosinophils), see comment.
    - NEGATIVE for acute appendicitis.

Comment:
The operative report describes an interval appendectomy; the finds would be compatible with that.

See also

References

  1. Quartey B (July 2012). "Interval appendectomy in adults: A necessary evil?". J Emerg Trauma Shock 5 (3): 213–6. doi:10.4103/0974-2700.99683. PMC 3440885. PMID 22988397. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440885/.
  2. de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW (July 2019). "Predictors for interval appendectomy in non-operatively treated complicated appendicitis". Int J Colorectal Dis 34 (7): 1325–1332. doi:10.1007/s00384-019-03303-4. PMID 31175422.
  3. 3.0 3.1 Guo G, Greenson JK (August 2003). "Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis". Am J Surg Pathol 27 (8): 1147–51. doi:10.1097/00000478-200308000-00013. PMID 12883248.
  4. 4.0 4.1 4.2 Malvar G, Peric M, Gonzalez RS (May 2022). "Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis". Histopathology 80 (6): 965–973. doi:10.1111/his.14621. PMID 35076982.