Difference between revisions of "Interval appendectomy"
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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 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> | |||
==Microscopic== | ==Microscopic== | ||
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*Muscularis propria eosinophils and/or [[plasma cell]]s. | *Muscularis propria eosinophils and/or [[plasma cell]]s. | ||
*+/-Muscularis propria [[neutrophil]]s. | *+/-Muscularis propria [[neutrophil]]s. | ||
*+/-Granulatous inflammation. | |||
DDx: | DDx: | ||
*[[Negative appendectomy]] - specimen should be [[submitted in toto]], no lymphoid hyperplasia, 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. | ||
*[[Mucinous_tumours_of_the_appendix|Mucinous tumour]] - | *[[Mucinous_tumours_of_the_appendix|Mucinous tumour]] - usually apparent on gross. | ||
*[[Appendiceal neuroendocrine tumour]]. | *[[Appendiceal neuroendocrine tumour]]. | ||
*[[Granulomatous appendicitis]]. | *[[Granulomatous appendicitis]]. | ||
*[[Crohn's disease]] of the appendix. | *[[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> | ||
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Revision as of 15:52, 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]
Microscopic
Features:
- Muscularis propria eosinophils and/or plasma cells.
- +/-Muscularis propria neutrophils.
- +/-Granulatous inflammation.
DDx:
- Negative appendectomy - specimen should be submitted in toto, no lymphoid hyperplasia, no chronic inflammation, history is essential.
- Adenovirus appendicitis - lymphoid hyperplasia.
- Mucinous tumour - usually apparent on gross.
- Appendiceal neuroendocrine tumour.
- Granulomatous appendicitis.
- Crohn's disease of the appendix - history is essential.[3]
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Vermiform Appendix, Appendectomy: - Benign appendix with mild mixed muscularis inflammation (plasma cells, eosinophils, possible rare neutrophils), see comment. Comment: The operative report describes an interval appendectomy; the finds would be compatible with that.
See also
References
- ↑ 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/.
- ↑ 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.
- ↑ 3.0 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.