Difference between revisions of "Negative appendectomy"

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==General==
==General==
*Common.
*Relatively common.
**Negative appendectomy rate higher with ultrasound than CT (8% versus 4%).<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>).
*Use for quality control among general surgeons.{{fact}}
**Rate higher in females than males (33% versus 12% in an Indian series assessed with US<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.


==Gross==
==Gross==
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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 section show appendiceal wall without increased numbers of neutrophils. 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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distortion of the crypt architecture. No granulomas are identified. No cryptitis  
distortion of the crypt architecture. No granulomas are identified. No cryptitis  
is identified.
is identified.
====Suspected fecal impaction====
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 mass lesion is present.


==See also==
==See also==
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[[Category:Gastrointestinal pathology]]
[[Category:Gastrointestinal pathology]]
[[Category:Diangosis]]
[[Category:Diagnosis]]
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