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Difference between revisions of "Interval appendectomy"
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Interval appendectomy (view source)
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==General== | ==General== | ||
*Done to exclude neoplasm and recurrent appendicitis.<ref name=pmid31175422>{{cite journal |authors=de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW |title=Predictors for interval appendectomy in non-operatively treated complicated appendicitis |journal=Int J Colorectal Dis |volume=34 |issue=7 |pages=1325–1332 |date=July 2019 |pmid=31175422 |doi=10.1007/s00384-019-03303-4 |url=}}</ref> | *Done to exclude neoplasm and prevent recurrent appendicitis.<ref name=pmid31175422>{{cite journal |authors=de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW |title=Predictors for interval appendectomy in non-operatively treated complicated appendicitis |journal=Int J Colorectal Dis |volume=34 |issue=7 |pages=1325–1332 |date=July 2019 |pmid=31175422 |doi=10.1007/s00384-019-03303-4 |url=}}</ref> | ||
*Histologically may mimic Crohn's disease.<ref name=pmid12883248>{{cite journal |authors=Guo G, Greenson JK |title=Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis |journal=Am J Surg Pathol |volume=27 |issue=8 |pages=1147–51 |date=August 2003 |pmid=12883248 |doi=10.1097/00000478-200308000-00013 |url=}}</ref> | *Histologically may mimic Crohn's disease.<ref name=pmid12883248>{{cite journal |authors=Guo G, Greenson JK |title=Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis |journal=Am J Surg Pathol |volume=27 |issue=8 |pages=1147–51 |date=August 2003 |pmid=12883248 |doi=10.1097/00000478-200308000-00013 |url=}}</ref><ref name=pmid35076982>{{cite journal |authors=Malvar G, Peric M, Gonzalez RS |title=Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis |journal=Histopathology |volume=80 |issue=6 |pages=965–973 |date=May 2022 |pmid=35076982 |doi=10.1111/his.14621 |url=}}</ref> | ||
==Microscopic== | ==Microscopic== | ||
Features: | Features:<ref name=pmid35076982/> | ||
*Muscularis propria eosinophils and/or [[plasma cell]]s. | *Muscularis propria eosinophils and/or [[plasma cell]]s. | ||
*+/-Fibrosis. | |||
*+/-Neutrophils in muscularis propria. | |||
*+/-Muscularis propria [[neutrophil]]s. | *+/-Muscularis propria [[neutrophil]]s. | ||
*+/-Granulatous inflammation. | *+/-Granulatous or xanthogranulomatous inflammation. | ||
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. | ||
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<pre> | <pre> | ||
Vermiform Appendix, Appendectomy: | Vermiform Appendix, Appendectomy: | ||
- Benign appendix with | - Benign appendix with mixed muscularis inflammation (plasma cells, eosinophils) and fibrosis, see comment. | ||
- NEGATIVE for acute appendicitis. | |||
Comment: | Comment: | ||
The operative report describes an interval appendectomy; the | The operative report describes an interval appendectomy; the findings would be compatible with that. | ||
</pre> | </pre> | ||
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==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Gastrointestinal pathology]] | [[Category:Gastrointestinal pathology]] | ||