Histopathological correlations of appendectomies: a clinical audit of a single center

Acute appendicitis is a common presentation in surgical assessment units and appendectomy accounts for a large number of emergency operations in the UK. Histopathological examination of the appendectomy specimens are routinely carried out. The aim of this study is to correlate the histological findings of appendectomy specimens with the clinical diagnosis of acute appendicitis.

This is a retrospective analysis of 238 appendectomies carried out in a single UK center between January and December 2013. The Histopathology reports of appendectomy specimens were retrieved.

A total of 238 appendectomies were performed during the study period. The mean age of the patients was 32 years (range, 7-81 years). Adult patients (>16 years) represented 79.4% of the study population. The female sex accounted for 46.6% of all the patients. Of the 238 resected appendix, 211 (88.7%) had histopathology findings consistent with appendicitis. Approximately 1.7% of the 238 specimens were abnormal pathologies other than inflammation of the appendix. The negative appendectomy (normal appendix on histology) rate was 11.3%. The female sex accounted for 59.1% of the negative appendectomies. Adults (>16 years) represented 77.8% of the negative appendectomies.

The observed high rates of negative appendectomy in the female sex can be reduced by utilizing combined clinical assessment and diagnostic imaging modalities. The findings of abnormal pathologies on histopathological examination of the appendix which could potentially impact on the management of the patients justify the current practice of routine histopathological examination of resected appendix.