1
|
Eslahi AV, Olfatifar M, Houshmand E, Abdoli A, Bijani B, Hashemipour S, Mahmoudi R, Hajialilo E, Javad Abbaszadeh Afshar M, Mohammadzadeh AR, Badri M. Parasites in surgically removed appendices as a neglected public health concern: a systematic review and meta-analysis. Pathog Glob Health 2022; 116:341-355. [PMID: 34842078 PMCID: PMC9387334 DOI: 10.1080/20477724.2021.2008701] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The role of various parasitic infections in the occurrence of appendicitis is illustrated through cases recorded all over the world. The purpose of the current study was to estimate the global prevalence of parasite infestation (other than E. vermicularis) in appendectomy specimens.In the setting of the PRISMA guidelines, multiple databases (Science Direct, Scopus, Web of Science, PubMed, and Google Scholar) were explored in articles published until 28 September 2020. Totally, 62 studies (106 datasets) with 77, 619 participants were included in the analysis.The pooled prevalence of parasites in appendectomy samples was as follows; 0.012% (95% CI; 0.004-0.025) for Ascaris lumbricoides, 0.004% (95% CI; 0.001-0.009) for Trichuris trichiura, 0.025% (95% CI; 0.007-0.052) for Schistosoma mansoni, 0.002% (95% CI; 0.001-0.005) for Taenia spp., 0.061% (95% CI; 0.020-0.122) for Entamoeba histolytica and 0.034% (95% CI; 0.018-0.056) for Giardia lamblia.Our results demonstrated that the risk of appendicitis may increase in the presence of helminth and protozoan infections. As such, the most cases of parasites in appendectomy specimens were reported in developing countries. Regular screening plans for diagnosis, treatment and prevention are needed for prevention of parasitic infection as well as parasitic associated appendicitis, especially in endemic regions of the world.
Collapse
Affiliation(s)
- Aida Vafae Eslahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Houshmand
- Department of Parasitology, Faculty of Veterinary Medicine, Rasht Branch, Islamic Azad University, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Behzad Bijani
- Clinical Research Development Unit, Kosar Hospital, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Razzagh Mahmoudi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Elham Hajialilo
- Department of Parasitology and Mycology, Qazvin University of Medical Sciences, Qazvin, Iran
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Ali Reza Mohammadzadeh
- Clinical Research Development Unit, Qods Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| |
Collapse
|
2
|
Reply to "Comment on the Correlation between Complete Blood Count Parameters and Appendix Diameter for the Diagnosis of Acute Appendicitis". Healthcare (Basel) 2020; 8:healthcare8040462. [PMID: 33167461 PMCID: PMC7711664 DOI: 10.3390/healthcare8040462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/08/2020] [Accepted: 10/22/2020] [Indexed: 11/21/2022] Open
|
3
|
Dincel O, Göksu M, Türk BA, Pehlivanoğlu B, İşler S. Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients. Indian J Surg 2016; 80:48-53. [PMID: 29581685 DOI: 10.1007/s12262-016-1557-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/07/2016] [Indexed: 12/19/2022] Open
Abstract
Diseases and tumors of the appendix vermiformis are very rare, except for acute appendicitis. This study aimed to examine rare findings in the histopathologic examinations of specimens of patients undergoing appendectomy due to the diagnosis of acute appendicitis. The files of 1970 patients undergoing appendectomy due to the diagnosis of acute appendicitis between March 2012 and March 2016 were retrospectively investigated. Rare findings were found in 59 (3 %) patients, and these were evaluated in detail. Patients' age, gender, pathology reports, and postoperation follow-ups were recorded. The rare histopathological findings of 59 patients were examined. Of these, 31 were female (52.5 %) and 28 were male (47.5 %). The average age was 33.1 ± 18.2 years. The unusual findings were as follows: 16 fibrous obliteration, 11 Enterobius vermicularis, 2 schistosomiasis, 3 appendiceal neuroma, 2 granulomatous appendicitis, 1 Crohn's disease, 3 chronic appendicitis, 1 endometriosis, 2 hyperplastic polyps, 9 mucinous cystadenoma (+mucocele), 8 carcinoid tumors, and 1 lymphoma. All of the malignant tumors were localized in the distal end of the appendix, and all of the patients were treated with appendectomy. Patients with parasitic diseases also underwent anthelmintic treatment, while chemotherapy was administered to the patient with lymphoma. All of the patients diagnosed with malignancy were alive reported no problems at their follow-ups. Although all of the appendectomy samples were normal macroscopically, data from this study suggest that all specimens should be sent for routine investigation.
Collapse
Affiliation(s)
- Oğuzhan Dincel
- 1Department of General Surgery, Faculty of Medicine, Adiyaman University, Yeni mah. 26294 sk. Elif Kent Sitesi B Blok No:2, Adiyaman, Turkey
| | - Mustafa Göksu
- 1Department of General Surgery, Faculty of Medicine, Adiyaman University, Yeni mah. 26294 sk. Elif Kent Sitesi B Blok No:2, Adiyaman, Turkey
| | - Bilge Aydın Türk
- 2Department of Pathology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Burçin Pehlivanoğlu
- 2Department of Pathology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Serap İşler
- 2Department of Pathology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| |
Collapse
|
4
|
An Ovarian Carcinoid Tumor With Peptide YY-Positive Insular Component: A Case Report and Review of the Literature. Int J Gynecol Pathol 2015; 35:362-8. [PMID: 26630222 DOI: 10.1097/pgp.0000000000000242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ovarian carcinoid tumors are uncommon and account for 1% of all carcinoid tumors. The insular type of ovarian carcinoid tumor is common in western countries; in contrast, the strumal and trabecular types seem to be common in Asian countries. Strumal and trabecular types are associated with peptide YY (PYY) production, which may cause constipation. Here, we report the case of a 70-yr-old Japanese woman with chronic constipation who was referred to Kumamoto University Hospital because of a right adnexal mass. Imaging tests suggested that the solid mass might be malignant; therefore, abdominal total hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. A subsequent histopathologic examination confirmed an insular carcinoid tumor with a trabecular component in the right ovary. Both components were positive for PYY but not for serotonin. The patient complained of diarrhea instead of constipation soon after the surgery. Because PYY-positive insular carcinoid tumor in the ovary has not been previously reported, we reviewed 19 reported cases of patients with PYY-positive ovarian carcinoid tumors. The origins, common histologic types and symptoms caused by specific peptides secreted in ovarian carcinoid tumors differ between western and Asian countries.
Collapse
|
5
|
He X, Huang J, Yao J, Chen Z, Lian L, Li S, Rouniyar S, Chen Y, Wu X, Lan P. Routine histopathologic examination of "benign" anal lesions: is it necessary? Surg Today 2015; 45:416-21. [PMID: 25604139 DOI: 10.1007/s00595-014-1090-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 09/02/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To establish the necessity of routine histopathologic examination of specimens from hemorrhoids and anal fistula that are diagnosed preoperatively. METHODS We reviewed histopathologic reports from hemorrhoidectomy and anal fistula excision operations performed between 2007 and 2011 in the sixth affiliated hospital of Sun Yat-sen University and Guangdong Province Traditional Chinese Medical Hospital. We evaluated the incidence of unexpected pathologic malignancy and its impact on postoperative management. RESULTS Among the 10532 patients recruited, 8308 had undergone hemorrhoidectomy and 2224 had undergone excision of an anal fistula. Unexpected pathologic malignancy was discovered in 17 specimens (0.16 %). Overall and subgroup analysis for risk factors of malignant detection revealed unexpected pathologic malignancy was more likely to be found in people over the age of 60 years (OR = 5.516, P = 0.002 overall and OR = 5.442, P = 0.007 for hemorrhoids). CONCLUSION Routine histopathologic examination of specimens from patients undergoing hemorrhoid or anal fistula surgery is of value for identifying unexpected pathologic malignancy. An age older than 60 years may be a remarkable risk factor.
Collapse
Affiliation(s)
- Xiaosheng He
- Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, 26 Yuancun Erheng Rd, Guangzhou, 510655, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Lin C, Li X, Guo Y, Hu G, Zhang Y, Yang K, Gan Y, Zhou J, Lv L, Gao K, Du J. Simultaneous giant mucinous cystadenoma of the appendix and intestinal schistosomiasis: 'case report and brief review'. World J Surg Oncol 2014; 12:385. [PMID: 25518977 PMCID: PMC4300777 DOI: 10.1186/1477-7819-12-385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 12/03/2014] [Indexed: 11/10/2022] Open
Abstract
Both mucinous cystadenoma of the appendix and intestinal schistosomiasis are rare lesions. We report a rare case of simultaneous giant mucinous cystadenoma of the appendix and intestinal schistosomiasis. A 64-year-old man from China presented with a one-year history of pain in the right lower quadrant of the abdomen. There were no other pertinent historical findings, other than schistosomiasis. Imaging showed a large, tubular, mesenteric cystic structure extending downwards from the inferior wall of the cecum. Right hemicolectomy was performed for the appendiceal tumor. The final pathological diagnosis was mucinous cystadenoma with calcified Schistosome eggs within the mucosa and submucosa of the appendix, small intestine, colon, and lymph nodes. We deduced that the pathogenesis of appendiceal mucinous cystadenoma in our case was Schistosome eggs causing luminal obstruction, finally resulting in intraluminal accumulation of mucoid material. Postoperatively, the patient recovered well.
Collapse
Affiliation(s)
| | - Xiaorong Li
- Department of General surgery, The Third XiangYa Hospital of Central South University, Tongzipo Road, Changsha 410013 Hunan, PR China.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Further exploration during open appendicectomy; assessment of some common intraoperative findings. Pak J Med Sci 2014; 30:316-21. [PMID: 24772134 PMCID: PMC3999001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 12/02/2013] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Very few studies are available to relate the final histology of excised appendix with the detailed intra-operative findings during appendectomy, both open and laparoscopic. This study was aimed to correlate the histological features of appendix specimen with the intra operative findings at open appendicectomy (OA) in a bid to determine when to change the planned procedure to include further exploration. Methods : A prospective study that observes the condition of the greater omentum (GO), the vermiform appendix and peritoneal exudates at all OA done for uncomplicated appendicitis. Histological examination of the appendices done using the H&E stain. Results : Eighty-five patients had emergency open OA, their(') ages range from 6 to 62 yrs (median = 23yrs). Histology showed 7 normal appendix (HNA), 56 acute (HAA) and 22 "non acute" appendicitis (HNAA). Negative appendicectomy rate was 8.2%. The GO was sighted more in patients with HAA than HNAA (p=0.00015) and also significantly more inflamed in the former (p=0.00028). It is not significantly inflamed in those with HNAA (p=0.945). The negative predictive value (NPV) of absent GO is 35.7% while the positive predictive value (PPV) of sighted normal GO and inflamed GO are 92.8% and 100% respectively. The PPV and NPV of presence of pus for diseased appendix are 95.8% and 9.8% respectively while those of excess fluid are 94.8% and 10.8%. The PPV and NPV of macroscopic assessment of the appendix for inflammation are 97% and 45.5% respectively giving the diagnostic accuracy of 90.6%. A significant trend of increasing probability of histologically inflamed appendix with increasing severity of macroscopic feature was seen (X(2) = 004 df=1, p<0.005). CONCLUSION High positive and low negative predictive values are similar for all the three parameters assessed. The macroscopic appearance of the appendix has a predictive likelihood ratio for further exploration.
Collapse
|
8
|
Yaylak F, Algin MC, Gungor Y, Korkmaz M. Atresia of the appendix vermiformis: A rare case of developmental abnormality. World J Gastroenterol 2013; 19:122-4. [PMID: 23326173 PMCID: PMC3542758 DOI: 10.3748/wjg.v19.i1.122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 10/15/2012] [Accepted: 10/30/2012] [Indexed: 02/06/2023] Open
Abstract
Acute appendicitis, which requires immediate surgical intervention, is an important diagnosis in patients with acute abdomen. However, developmental abnormalities may interfere with the preoperative diagnosis and surgical treatment in some cases. Agenesis and atresia of the cecal vermiform appendix is an extremely rare clinical diagnosis. In addition, preoperative diagnosis may be difficult in some cases. Thus, diagnosis of the congenital absence of the vermiform appendix requires a thorough exploration of the retrocecal and ileocecal regions. A 59-year-old male was admitted from the emergency services with right lower abdominal pain. A celiotomy was performed with the suspicion of acute appendicitis. However, an atresia of the vermiform appendix was observed. The patient’s appendix was thus removed. Pathological examination confirmed suppurative appendicitis. This case underlines the importance of the clinical entity for surgeons who may deal with a similar case.
Collapse
|
9
|
Swank HA, Eshuis EJ, Ubbink DT, Bemelman WA. Is routine histopathological examination of appendectomy specimens useful? A systematic review of the literature. Colorectal Dis 2011; 13:1214-21. [PMID: 20958910 DOI: 10.1111/j.1463-1318.2010.02457.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM Histopathological examination of the appendix after appendectomy is routinely performed. The object of this systematic review is to determine whether routine histopathological examination of the appendix is justified. METHOD PubMed, EMBASE, Web of Science and the Cochrane library were searched without language restriction up to 1 October 2009. All articles that reported on the incidence of histopathologically proven aberrant appendiceal pathology were included. RESULTS Nineteen case series reported the incidence of a benign neoplasm [0.5%, weighted mean (WM)], malignant neoplasm (0.2%, WM) and other pathology (0-14%). Nine articles reported the sensitivity of the intra-operative findings to detect aberrant diagnoses. Parasitic infection was detected in 0-19%, endometriosis in 0% and granulomatosis in 0-11% of cases. Five articles addressed the consequences of aberrant pathology. Most patients with parasite infection, granulomatosis and malignant neoplasms underwent additional investigation or treatment, in contrast to patients with a benign neoplasm. CONCLUSION The incidence of unexpected findings in appendectomy specimens is low and the intra-operative diagnosis alone appears insufficient for identifying unexpected disease. The benefit of histopathology is studied inadequately. From the present available evidence, routine histopathology cannot be judged as useless.
Collapse
Affiliation(s)
- H A Swank
- Department of Surgery, Academic Medical Centre, Amsterdam, the Netherlands
| | | | | | | |
Collapse
|
10
|
Bodin R, Peycru T, Schwartz A, Jarry J, Pommier N, Durand-Dastes F. Tubulovillous adenoma of the appendix: a case report and review of the literature. GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 2010; 34:633-5. [PMID: 20739133 DOI: 10.1016/j.gcb.2010.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Revised: 07/01/2010] [Accepted: 07/05/2010] [Indexed: 10/19/2022]
Abstract
We report the case of a young woman hospitalized for a chronic appendicular syndrome. The histological examination of the resected specimen revealed a rare tumor: tubulovillous adenoma, discovered in 0.02% of all appendectomy procedures. Treatment is most often limited to appendectomy, but in the event of incomplete excision or associated adenocarcinoma, right hemicolectomy may be required. After surgery, a follow-up colonoscopy is recommended due to the higher risk of second gastrointestinal neoplasms in patients with appendicular tumors.
Collapse
Affiliation(s)
- R Bodin
- Service de chirurgie viscérale, hôpital d'instruction des armées Robert-Picqué, 351, route de Toulouse, CS 80002, 33882 Villenave D'ornon, France.
| | | | | | | | | | | |
Collapse
|
11
|
Patel AV, Friedman M, MacDermott RP. Crohn's disease patient with right lower quadrant abdominal pain for 20 years due to an appendiceal neuroma (Fibrous obliteration of the appendix). Inflamm Bowel Dis 2010; 16:1093-4. [PMID: 19824068 DOI: 10.1002/ibd.21143] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
12
|
Li AFY, Hsu CY, Li A, Tai LC, Liang WY, Li WY, Tsay SH, Chen JY. A 35-year retrospective study of carcinoid tumors in Taiwan: differences in distribution with a high probability of associated second primary malignancies. Cancer 2008; 112:274-83. [PMID: 18008361 DOI: 10.1002/cncr.23159] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND A comprehensive study of carcinoid tumors from United States-based databases indicated that the small intestine, colon, rectum, and bronchopulmonary system are common locations for carcinoid tumors. In addition, certain carcinoid tumors, such as rectal carcinoids, appeared to be overrepresented in nonwhite populations in the United States. High frequencies of associated noncarcinoid malignancies were reported in some articles. The objective of the current study was to address the organ distribution, frequency of metastasis, and survival rates of carcinoid tumors and the associated noncarcinoid tumors in Taiwanese, Asian populations. METHODS Two hundred twenty-eight patients with carcinoid tumors were identified and evaluated from the surgical pathology files and medical records of the Veterans General Hospital, Taipei, Taiwan from January 1970 to December 2005. RESULTS In 228 carcinoid tumors that were analyzed, the rectum (60.5%) was the most common location followed by the lung (20.2%) and the thymus (6.6%). Metastatic lesions were demonstrated in 16.2% of patients. Disease extent was associated with survival. The 5-year survival rates for patients with localized, regional metastatic, and distant metastatic disease were 94.1%, 49.1%, and 0%, respectively (P< .001). Associated noncarcinoid malignancies were noted in 14% of patients with carcinoids, mainly in the gastrointestinal tract (52.9%), lung, and genitourinary system. CONCLUSIONS A different organ distribution of carcinoids was observed in Taiwanese patients, who had with significantly more carcinoids located in the rectum and thymus compared with patients in Western countries. The patients with carcinoids in the current study had a high possibility of developing associated, noncarcinoid neoplasms. Surveillance of the colon, stomach, lung, and genitourinary system for second malignant tumors is recommended.
Collapse
Affiliation(s)
- Anna Fen-Yau Li
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Jones AE, Phillips AW, Jarvis JR, Sargen K. The value of routine histopathological examination of appendicectomy specimens. BMC Surg 2007; 7:17. [PMID: 17692116 PMCID: PMC1976308 DOI: 10.1186/1471-2482-7-17] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2006] [Accepted: 08/10/2007] [Indexed: 11/18/2022] Open
Abstract
Background Appendicectomy specimens removed from patients with suspected acute appendicitis often appear macroscopically normal but histopathological analysis of these cases may reveal a more sinister underlying pathology. We evaluated histopathological reports of 1225 appendicectomy specimens at the Norfolk and Norwich University Hospital (NNUH) over the past three years. Methods Histopathology reports for all appendices analysed at the NNUH between March 2003 and March 2006 were reviewed by examination of the case notes. The analysis focussed on the confirmation of acute appendicitis, incidental unexpected incidental findings other than inflammation, whether these abnormalities were suspected on gross examination at the time of surgery, and the effect on patient management and prognosis. Results The histopathology reports disclosed a variety of abnormal incidental lesions. Of the 1225 specimens, 46 (3.75%) revealed abnormal diagnoses other than inflammatory changes. Twenty-four (1.96%) of these were clinically significant and affected further patient management. Only two of these (0.16%) were suspected on macroscopic examination intra-operatively. Conclusion Twenty-four of the 1225 specimens (1.96%) had an impact on patient management or outcome and were not suspected on macroscopic examination at the time of surgery. These would have been missed had the specimens not been examined microscopically. The intra-operative diagnosis of the surgeon is therefore unreliable in detecting abnormalities of the appendix. This study supports the sending of all appendicectomy specimens for routine histopathological examination.
Collapse
Affiliation(s)
- Alun E Jones
- Department of General Surgery, Norfolk and Norwich University Hospital NHS Trust, Colney Road, Norwich, NR5 7UR, England, UK
| | - Alexander W Phillips
- Department of General Surgery, Norfolk and Norwich University Hospital NHS Trust, Colney Road, Norwich, NR5 7UR, England, UK
| | - John R Jarvis
- Department of General Surgery, Norfolk and Norwich University Hospital NHS Trust, Colney Road, Norwich, NR5 7UR, England, UK
| | - Kevin Sargen
- Department of General Surgery, Norfolk and Norwich University Hospital NHS Trust, Colney Road, Norwich, NR5 7UR, England, UK
| |
Collapse
|
14
|
Rhoades T, Lohr J, Jennings M. Symptoms of Acute Appendicitis Caused by Primary Neuroma of the Appendix. Am Surg 2007. [DOI: 10.1177/000313480707300825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Torre Rhoades
- Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio
| | - Joann Lohr
- Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio
| | - Mark Jennings
- Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio
| |
Collapse
|
15
|
Matthyssens LE, Ziol M, Barrat C, Champault GG. Routine surgical pathology in general surgery. Br J Surg 2006; 93:362-8. [PMID: 16470713 DOI: 10.1002/bjs.5268] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although pathological analysis provides the definitive diagnosis for most resection specimens, recent evidence suggests that such analysis may be omitted for certain routine samples. This was a retrospective analysis of the value of routine histopathological examination performed in daily general surgical practice. METHODS All specimens from routine appendicectomies, cholecystectomies, haemorrhoidectomies and inguinal hernia repairs performed between 1993 and 2002 were included. The analysis included a comparison of histological and macroscopic diagnoses, review of preoperative and peroperative findings, and an evaluation of the consequences of routine histopathological assessment on patient management and costs. RESULTS With the exception of hernia specimens, the rate of submission for routine pathological evaluation was 100 per cent. No hernia sac specimen from more than 2000 interventions revealed aberrant histological findings. Of 311 haemorrhoidectomy specimens three showed malignancy, all of which had a suspicious macroscopic appearance. Of 1465 appendices, only one (0.1 per cent) had a potentially relevant histological diagnosis that was not suspected macroscopically. Among 1523 cholecystectomy specimens, all adenomas (0.6 per cent) and carcinomas (0.4 per cent) were suspected macroscopically or developed in association with a known disease. CONCLUSION The rarity of incidental histological findings relevant to patient management, especially in the absence of macroscopic abnormalities, suggests that routine histological examination of certain specimens may be omitted. A more elementary role for macroscopic examination of the specimen by the surgeon and the pathologist is proposed.
Collapse
Affiliation(s)
- L E Matthyssens
- Department of General and Digestive Surgery, Université Paris-XIII, Paris, France.
| | | | | | | |
Collapse
|
16
|
Abstract
AIMS To investigate the incidence of melanosis of the vermiform appendix in a paediatric population, and look for correlations with season, apoptotic rate and inflammation as possible causes. METHODS AND RESULTS We examined 300 appendices removed for abdominal pain and incidentally during other procedures over the period January 1996 to March 1999. Melanosis was present in 46% of adequate specimens with an even distribution between sexes and age groups. The two older age groups had a relatively higher incidence of severe involvement compared with the younger age group, although the difference was not statistically significant. We attempted to correlate the presence of melanosis with the season of the year and the peak incidences of paediatric gastrointestinal disease but could find no relationship. No statistically significant correlation was found between apoptotic rate and the presence of melanosis. CONCLUSIONS The findings suggest melanosis of the appendix is relatively common. It is probably due to apoptosis associated with increased epithelial cell turnover due to many differing causes including infection, with purgative ingestion probably involved in only a minority of paediatric cases.
Collapse
Affiliation(s)
- N S Graf
- Histopathology Department, Royal Alexandra Hospital for Children, Westmead, Sydney, Australia
| | | |
Collapse
|
17
|
Miraliakbari R, Chapman WH. Laparoscopic treatment of an appendiceal mucocele. J Laparoendosc Adv Surg Tech A 1999; 9:159-63. [PMID: 10235354 DOI: 10.1089/lap.1999.9.159] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Appendiceal mucocele is a rare entity with a nonspecific preoperative presentation and is diagnosed intraoperatively in a majority of cases. The emphasis lies in accurate pathologic diagnosis, as the final treatment can differ depending on the malignant potential. The case presented was correctly diagnosed preoperatively. Laparoscopic exploration was both diagnostic and therapeutic. This case demonstrates the utility and safety of laparoscopy in the treatment of appendiceal masses.
Collapse
Affiliation(s)
- R Miraliakbari
- Department of Surgery, University Medical Systems of Pitt County, Greenville, North Carolina, USA
| | | |
Collapse
|
18
|
Affiliation(s)
- P A Singh
- Department of Pathology, MLN Medical College, Allahabad, India
| | | | | |
Collapse
|
19
|
Dorfman S, Talbot IC, Torres R, Cardozo J, Sanchez M. Parasitic infestation in acute appendicitis. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 1995; 89:99-101. [PMID: 7741603 DOI: 10.1080/00034983.1995.11812938] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- S Dorfman
- Department of Surgery, Hospital General del Sur, Maracaibo, Venezuela
| | | | | | | | | |
Collapse
|
20
|
Stringer MD. Carcinoid tumours of the appendix in children 1957-1986: incidence, treatment and outcome. Br J Surg 1993; 80:1217. [PMID: 8402142 DOI: 10.1002/bjs.1800800961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
21
|
Wettergren A, Munkholm P, Larsen LG, Meinecke B, Langholz E, Jess P, Binder V. Granulomas of the appendix: is it Crohn's disease? Scand J Gastroenterol 1991; 26:961-4. [PMID: 1947789 DOI: 10.3109/00365529108996249] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
An epidemiologic study was performed 1) to estimate the occurrence of epithelioid granulomas in the appendix wall among patients in whom an appendectomy had been performed, 2) to identify patients with granulomas in the appendix who had symptoms and history compatible with Crohn's disease, and 3) to estimate the long-term prognosis. Within a 5-year period 6051 patients in Copenhagen County underwent appendectomy. Six patients (0.1%) had epithelioid granulomas of the appendix (0.2 per 10(5) inhabitants per year). Follow-up of the six patients for 9-11 years (median, 9.5 years) showed that all had been free of gastrointestinal symptoms since the operation. Among the 373 patients diagnosed as having Crohn's disease in Copenhagen County between 1962 and 1987, 3 patients had their disease initially confined to the appendix. Follow-up in these patients showed no recurrence within a median of 6 years (range, 4-7 years). Patients with epithelioid granulomas of the appendix have an excellent long-term prognosis, which could be explained by the fact that the condition seems to be unrelated to Crohn's disease.
Collapse
Affiliation(s)
- A Wettergren
- Dept. of Gastrointestinal Surgery, Glostrup Hospital, Copenhagen, Denmark
| | | | | | | | | | | | | |
Collapse
|
22
|
Gupta SC, Gupta AK, Keswani NK, Singh PA, Tripathi AK, Krishna V. Pathology of tropical appendicitis. J Clin Pathol 1989; 42:1169-72. [PMID: 2584431 PMCID: PMC501976 DOI: 10.1136/jcp.42.11.1169] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
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.
Collapse
Affiliation(s)
- S C Gupta
- Department of Pathology and Surgery, MLN Medical College, Allahabad, India
| | | | | | | | | | | |
Collapse
|
23
|
|
24
|
|