Interval appendectomy

Interval appendectomy is an appendectomy following the presentation of acute appendicitis.

General

• Done to exclude neoplasm and recurrent appendicitis.
• Histologically may mimic Crohn's disease.

Microscopic

Features:

• Muscularis propria eosinophils and/or plasma cells.
• +/-Muscularis propria neutrophils.
• +/-Granulatous inflammation.

DDx:

• Negative appendectomy - specimen should be submitted in toto, no lymphoid hyperplasia, no chronic inflammation, history is essential.
• Adenovirus appendicitis - lymphoid hyperplasia.
• Mucinous tumour - usually apparent on gross.
• Appendiceal neuroendocrine tumour.
• Granulomatous appendicitis.
• Crohn's disease of the appendix - history is essential.

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Vermiform Appendix, Appendectomy:
	- Benign appendix with mild mixed muscularis inflammation (plasma cells, eosinophils, possible rare neutrophils), see comment.

Comment:
The operative report describes an interval appendectomy; the finds would be compatible with that.

See also

• Granulomatous appendicitis.
• Negative appendectomy.