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'''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]] | |||