Interval appendectomy

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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][4]

Microscopic

Features:[4]

  • Muscularis propria eosinophils and/or plasma cells.
  • +/-Fibrosis.
  • +/-Neutrophils in muscularis propria.
  • +/-Muscularis propria neutrophils.
  • +/-Granulatous or xanthogranulomatous inflammation.

DDx:

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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 finds 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.