A Clinicopathological Review of 655 Appendices Removed For Acute Appendicitis in a Tertiary Care Medical Center in Lebanon: A Retrospective Study

Abstract

Context: Acute appendicitis is the most commonly performed emergency abdominal surgery. A variety of conditions can mimic it. Aims: This study aims to determine the pathological diagnosis in appendectomy specimens. Methods and Materials: This is a retrospective analysis of 655 patients who underwent appendectomy in a tertiary care centre between January 2007 and February 2018. Demographic information was gathered. The results were analysed using SPSS statistics software. Results: 655 patients were included (male to female ratio: 1.46/1). The mean age was 31.9 years. Histopathological findings were abnormal in 514 (78.4%) including uncomplicated appendicitis 442 (67.4%), perforated appendicitis 26 (3.97%), necrotic gangrenous appendicitis 7 (1.1%), accidental appendicitis 5 (0.76%), purulent appendicitis 4 (0.6%), congestion 11 (1.67%), fecaloma 8 (1.22%) and unusual findings in 13 patients. The perforation rate was 7.6%. Patients with pathologically normal appendices were significantly older than those with abnormal appendices (P<0.05). Abnormal findings were more seen in males (p<0.05). The false appendectomy rate for appendicitis was 12.8% (75 cases), Gender was determined to have a significant effect on this rate (P<0.05) which was more seen in females (60%) while age had no effect on it. Conclusion: The variety of pathological results post appendectomy verifies the continuous need for histopathological studies to confirm the diagnosis. False appendectomy rate is more common in females which suggest the need of laparoscopy in this group.