Unusual Findings in Appendectomy: Experience in a Third Level Hospital with More than 1000 Specimens

Abstract

Introduction and Aims: Acute appendicitis is a commonly established diagnosis in the approach of abdominal pain. It is usually due to an acute inflammatory process in the appendix. Nevertheless, there is a small percentage of cases due to non-frequent etiologies that are only identifiable based on histopathological analysis. The aim of this study was to determine the prevalence and characterization of these unusual findings. Materials and Methods: The present study was a cross-sectional study in a third-level hospital in Mexico City. Clinical information was collected from unusual findings in the histopathological analysis of 1018 appendectomy specimens between January 2012 and April 2017. Results: In total, 1018 appendectomy specimens were included. In 11 of those appendices (1.08%), unusual findings compatible with appendicular tumors were identified. Carcinoid tumor found in the tip of the appendix was the most frequently reported finding. The muscular layer was affected in most cases; up to 25% of regional ganglia were invaded. Most of the patients presented with abdominal pain and clinical signs suggestive of acute appendicitis. The preferred approach for surgical treatment was laparoscopic. Discussion and Conclusion: The prevalence of unusual findings in our population was 1.08%, with carcinoid tumors the most frequently established diagnosis among those (0.58%), according to previously reported literature data.