Interval appendectomy
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Interval appendectomy is an appendectomy following the presentation of acute appendicitis.[1]
General
- Done to exclude neoplasm and 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:
- Acute appendicitis - history is essential to differentiate.
- An interval appendectomy may have active inflammation.[4]
- 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.[3]
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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 finds would be compatible with that.
See also
References
- ↑ 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/.
- ↑ 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.
- ↑ 3.0 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.
- ↑ 4.0 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.