Difference between revisions of "Interval appendectomy"

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==General==
==General==
*Done to exclude neoplasm and recurrent appendicitis.<ref name=pmid31175422>{{cite journal |authors=de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW |title=Predictors for interval appendectomy in non-operatively treated complicated appendicitis |journal=Int J Colorectal Dis |volume=34 |issue=7 |pages=1325–1332 |date=July 2019 |pmid=31175422 |doi=10.1007/s00384-019-03303-4 |url=}}</ref>
*Done to exclude neoplasm and prevent recurrent appendicitis.<ref name=pmid31175422>{{cite journal |authors=de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW |title=Predictors for interval appendectomy in non-operatively treated complicated appendicitis |journal=Int J Colorectal Dis |volume=34 |issue=7 |pages=1325–1332 |date=July 2019 |pmid=31175422 |doi=10.1007/s00384-019-03303-4 |url=}}</ref>
*Histologically may mimic Crohn's disease.<ref name=pmid12883248>{{cite journal |authors=Guo G, Greenson JK |title=Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis |journal=Am J Surg Pathol |volume=27 |issue=8 |pages=1147–51 |date=August 2003 |pmid=12883248 |doi=10.1097/00000478-200308000-00013 |url=}}</ref><ref name=pmid35076982>{{cite journal |authors=Malvar G, Peric M, Gonzalez RS |title=Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis |journal=Histopathology |volume=80 |issue=6 |pages=965–973 |date=May 2022 |pmid=35076982 |doi=10.1111/his.14621 |url=}}</ref>


==Microscopic==
==Microscopic==
Features:
Features:<ref name=pmid35076982/>
*Muscularis propria eosinophils and/or plasma cells.
*Muscularis propria eosinophils and/or [[plasma cell]]s.
*+/-Muscularis propria neutrophils.
*+/-Fibrosis.
*+/-Neutrophils in muscularis propria.
*+/-Muscularis propria [[neutrophil]]s.
*+/-Granulatous or xanthogranulomatous inflammation.


DDx:
DDx:
*[[Negative appendectomy]] - specimen should be [[submitted in toto]], no lymphoid hyperplasia, history is essential.
*[[Acute appendicitis]] - history is essential to differentiate.
**An interval appendectomy may have active inflammation.<ref name=pmid35076982/>
*[[Negative appendectomy]] - specimen should be [[submitted in toto]], no lymphoid hyperplasia, no chronic inflammation, history is essential.
*[[Adenovirus appendicitis]] - lymphoid hyperplasia.
*[[Adenovirus appendicitis]] - lymphoid hyperplasia.
*[[Mucinous_tumours_of_the_appendix|Mucinous tumour]] - usu. apparent on gross.
*[[Mucinous_tumours_of_the_appendix|Mucinous tumour]] - usually apparent on gross.
*[[Appendiceal neuroendocrine tumour]].
*[[Appendiceal neuroendocrine tumour]].
*[[Granulomatous appendicitis]].
*[[Granulomatous appendicitis]].
*[[Crohn's disease]] of the appendix.
*[[Crohn's disease]] of the appendix - history is essential.<ref name=pmid12883248>{{cite journal |authors=Guo G, Greenson JK |title=Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis |journal=Am J Surg Pathol |volume=27 |issue=8 |pages=1147–51 |date=August 2003 |pmid=12883248 |doi=10.1097/00000478-200308000-00013 |url=}}</ref>


==Sign out==
==Sign out==
<pre>
<pre>
Vermiform Appendix, Appendectomy:
Vermiform Appendix, Appendectomy:
- Benign appendix with mild mixed muscularis inflammation (plasma cells, eosinophils, possible rare neutrophils), see comment.
- Benign appendix with mixed muscularis inflammation (plasma cells, eosinophils) and fibrosis, see comment.
- NEGATIVE for acute appendicitis.


Comment:
Comment:
The operative report describes an interval appendectomy; the finds would be compatible with that.
The operative report describes an interval appendectomy; the findings would be compatible with that.
</pre>
</pre>


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==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Gastrointestinal pathology]]
[[Category:Gastrointestinal pathology]]

Latest revision as of 17:45, 20 December 2023

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:

Sign out

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. 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. 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.