Difference between revisions of "Interval appendectomy"

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#redirect [[Granulomatous appendicitis]]
'''Interval appendectomy''' is an appendectomy following the presentation of [[acute appendicitis]].<ref name=pmid22988397>{{cite journal |authors=Quartey B |title=Interval appendectomy in adults: A necessary evil? |journal=J Emerg Trauma Shock |volume=5 |issue=3 |pages=213–6 |date=July 2012 |pmid=22988397 |pmc=3440885 |doi=10.4103/0974-2700.99683 |url=}}</ref>
 
==General==
*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><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==
Features:<ref name=pmid35076982/>
*Muscularis propria eosinophils and/or [[plasma cell]]s.
*+/-Fibrosis.
*+/-Neutrophils in muscularis propria.
*+/-Muscularis propria [[neutrophil]]s.
*+/-Granulatous or xanthogranulomatous inflammation.
 
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.
*[[Adenovirus appendicitis]] - lymphoid hyperplasia.
*[[Mucinous_tumours_of_the_appendix|Mucinous tumour]] - usually apparent on gross.
*[[Appendiceal neuroendocrine tumour]].
*[[Granulomatous appendicitis]].
*[[Crohn's disease]] of the appendix - history is essential.<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>
 
==Sign out==
<pre>
Vermiform Appendix, Appendectomy:
- Benign appendix with mixed muscularis inflammation (plasma cells, eosinophils) and fibrosis, see comment.
- NEGATIVE for acute appendicitis.
 
Comment:
The operative report describes an interval appendectomy; the findings would be compatible with that.
</pre>
 
==See also==
*[[Granulomatous appendicitis]].
*[[Negative appendectomy]].
 
==References==
{{Reflist|2}}
 
[[Category:Gastrointestinal pathology]]

Latest revision as of 17:45, 20 December 2023

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

General

  • Done to exclude neoplasm and prevent 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:

Sign out

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

Comment:
The operative report describes an interval appendectomy; the findings 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.
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