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Difference between revisions of "Negative appendectomy"
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*Relatively common. | *Relatively common. | ||
**Rate higher with ultrasound (US) than computed tomography (CT) (8% versus 4% in one series<ref name=pmid26990317>{{Cite journal | last1 = Lee | first1 = J. | last2 = Ko | first2 = Y. | last3 = Ahn | first3 = S. | last4 = Park | first4 = JH. | last5 = Kim | first5 = HJ. | last6 = Hwang | first6 = SS. | last7 = Lee | first7 = KH. | title = Comparison of US and CT on the effect on negative appendectomy and appendiceal perforation in adolescents and adults: A post-hoc analysis using propensity-score methods. | journal = J Clin Ultrasound | volume = | issue = | pages = | month = Mar | year = 2016 | doi = 10.1002/jcu.22351 | PMID = 26990317 }}</ref>). | **Rate higher with ultrasound (US) than computed tomography (CT) (8% versus 4% in one series<ref name=pmid26990317>{{Cite journal | last1 = Lee | first1 = J. | last2 = Ko | first2 = Y. | last3 = Ahn | first3 = S. | last4 = Park | first4 = JH. | last5 = Kim | first5 = HJ. | last6 = Hwang | first6 = SS. | last7 = Lee | first7 = KH. | title = Comparison of US and CT on the effect on negative appendectomy and appendiceal perforation in adolescents and adults: A post-hoc analysis using propensity-score methods. | journal = J Clin Ultrasound | volume = | issue = | pages = | month = Mar | year = 2016 | doi = 10.1002/jcu.22351 | PMID = 26990317 }}</ref>). | ||
**Rate higher in females than males (33% versus 12% in an Indian series assessed with | **Rate higher in females than males (33% versus 12% in an Indian series assessed with ultrasound<ref name=pmid27011482>{{Cite journal | last1 = Joshi | first1 = MK. | last2 = Joshi | first2 = R. | last3 = Alam | first3 = SE. | last4 = Agarwal | first4 = S. | last5 = Kumar | first5 = S. | title = Negative Appendectomy: an Audit of Resident-Performed Surgery. How Can Its Incidence Be Minimized? | journal = Indian J Surg | volume = 77 | issue = Suppl 3 | pages = 913-7 | month = Dec | year = 2015 | doi = 10.1007/s12262-014-1063-0 | PMID = 27011482 }}</ref>). | ||
*Used for quality control among general surgeons. | *Used for quality control among general surgeons. | ||
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DDx: | DDx: | ||
*[[Acute appendicitis]]. | *[[Acute appendicitis]]. | ||
*[[Interval appendectomy]] - clinical history is essential. | |||
**Often have chronic inflammation and fibrosis. May have active inflammation. | |||
*[[Adenovirus appendicitis]]. | *[[Adenovirus appendicitis]]. | ||
*[[Appendiceal neuroendocrine tumour]]. | *[[Appendiceal neuroendocrine tumour]]. | ||
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**Isolated [[periappendicitis]]. | **Isolated [[periappendicitis]]. | ||
*[[Crypt cell carcinoma]] - [[AKA]] ''goblet cell carcinoid''. | *[[Crypt cell carcinoma]] - [[AKA]] ''goblet cell carcinoid''. | ||
*Appendix with ''[[Enterobius vermicularis]]'' - organisms in the lumen of the appendix. | |||
==Sign out== | ==Sign out== | ||
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====Alternate==== | ====Alternate==== | ||
The | The sections show appendiceal wall without increased numbers of neutrophils. The | ||
appendiceal lumen has cellular debris and inflammatory cells. The mucosa has prominent lymphoid tissue | appendiceal lumen has cellular debris and inflammatory cells. The mucosa has prominent lymphoid tissue | ||
with germinal centre formation. | with germinal centre formation. | ||
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====Suspected fecal impaction==== | ====Suspected fecal impaction==== | ||
The | The sections show appendiceal wall without increased numbers of neutrophils. The appendiceal lumen has compact fecal material, cellular debris and inflammatory cells. The mucosa has prominent lymphoid tissue with germinal centre formation. | ||
No intraluminal pathologic micro-organisms are seen. There is no serositis. There is no distortion of the crypt architecture. No granulomas are identified. No cryptitis is identified. | No intraluminal pathologic micro-organisms are seen. There is no serositis. There is no distortion of the crypt architecture. No granulomas are identified. No cryptitis is identified. No mass lesion is present. | ||
==See also== | ==See also== | ||