The investigation of appendiceal size and volume in pediatric appendectomy specimens in terms of histopathological diagnosis, seasonal variability, age, and gender
The investigation of appendiceal size and volume in appendectomies
Keywords:Appendectomy, appendicitis, carcinoid, fibrous obliteration, Enterobius vermicularis, pediatric specimens
Aim: Acute appendicitis is a common condition mostly in children with unclear etiology that is treated with an emergency appendectomy. However, some unexpected diagnoses called as "negative appendectomy" that do not require treatment may be detected histopathologically. In this study, it was aimed to investigate the histopathologic diagnoses of pediatric appendectomy specimens, considering the macroscopic dimensions and volume of the specimens for the first time in the literature and comparing them with age and gender groups, and seasons of the operations to achieve additional data in preventing negative appendectomy.
Materials and Methods: A total of 122 cases were included in this study. The length, longest diameter, and shortest diameter, as well as the volume of each specimen, were measured during the macroscopic examination. The specimens were evaluated for histopathologic diagnosis according to age, gender, and the season in which the operation was performed.
Results: The male-to-female ratio was 1.2. Histopathologically, there were 81 (74.6%) inflammatory [mainly acute appendicitis (65.5%)], and 31 (25.4%) non-inflammatory diseases [mainly lymphoid hyperplasia (21.3%)] that were considered negative appendectomy. Inflammatory diseases were operated mostly in winter (p=0.0099), while non-inflammatory diseases were operated mainly in autumn (p=0.0099). The length, longest diameter (y), and appendiceal volume were significantly greater in inflammatory than in non-inflammatory ones (p=0.0006, p=0.0126, and p=0.0016, respectively). Length and volume were more significant in acute appendicitis than in lymphoid hyperplasia (p=0.0124 and p=0.0358, respectively). In patients ≤12 years, lymphoid hyperplasia was more common in females than in males (p<0.001). In patients >12 years, acute appendicitis was more common in females than males (p<0.034).
Conclusion: The current study highlights the main differences between the diseases detected in appendectomies according to the macroscopical appendiceal size and volume for the first time in the literature, along with age and sex, and seasonal variations which could provide the literature with additional data on epidemiology, an appropriate preoperative, and pathological approach.
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