Incidental appendectomy at the time of surgery for ectopic pregnancy

Use of the appendix in reconstructive surgery: a case against incidental appendicectomy

Ignored for years, the appendix is once again being promoted as having useful surgical potential, notably in the management of incontinence. Incidental and prophylactic appendicectomy with their established complications become less easy to justify as the incidence of appendicitis declines. The role of the appendix in reconstructive surgery is reviewed, with particular reference to urinary reconstruction and to the treatment of chronically constipated or faecally incontinent children by use of the antegrade continence enema.

Pathology of tropical appendicitis

Over the past 25 years, 2921 appendicectomies were performed at this hospital. All were subjected to routine histopathological examination. In 95% of cases, histopathological examination did not add any further information but in 153 (5%) cases, clinically important pathological findings were detected for the first time. Seventy (2.3%) specimens showed typical evidence of tuberculosis. Parasitic infestation was detected in 75 (2.5%), including enterobiasis (1.4%), amoebiasis (0.5%), ascariasis (0.5%), ascariasis with trichuriasis (0.05%), and taeniasis (0.05%). Other lesions found were mucocele (0.1%) and carcinoid tumour (0.1%). It is concluded that routine histopathological examination of all appendicectomy specimens should be performed to avoid missing any clinically important and treatable condition.

Abdominal pain unrelated to trauma

This article reviews the more common causes of abdominal pain in children. It is divided into three sections to emphasize differential diagnosis. For some problems responsible for abdominal pain surgery is essential, for some surgery may not be initially required but may be unavoidable, and for others the condition is purely medical and surgery should be avoided. Armed with a complete differential diagnosis, the general surgical resident may avoid many pitfalls.