Interval appendectomy

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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:

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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 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. Jump up to: 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. Jump up to: 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.