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Periappendicitis and diagnostic consequences.

A V Bloch1, K F Kock, L Saxtoft Hansen

  • 1Department of Surgical Gastroenterology, Aalborg Sygehus, Denmark.

Annales Chirurgiae Et Gynaecologiae
|January 1, 1988
PubMed
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Periappendicitis, inflammation of the appendix outer layer, was diagnosed microscopically in 1.9% of appendectomies. This condition often mimics other intraperitoneal inflammation, highlighting the need for clinical awareness.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Abdominal Surgery

Background:

  • Appendicectomy is a common surgical procedure for suspected appendicitis.
  • Microscopic diagnosis of periappendicitis is infrequently encountered.
  • Periappendicitis can present with symptoms mimicking other intra-abdominal inflammatory conditions.

Purpose of the Study:

  • To determine the incidence of microscopic periappendicitis in a large series of appendicectomies.
  • To analyze the clinical and operative findings in patients with periappendicitis.
  • To emphasize the importance of recognizing periappendicitis due to its potential for diagnostic confusion.

Main Methods:

  • Retrospective analysis of 2660 appendicectomy cases over a ten-year period.
  • Review of microscopic pathological diagnoses.

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  • Correlation of pathological findings with intraoperative assessments and clinical data.

    • Main Results:

    • Microscopic periappendicitis was diagnosed in 50 cases (1.9%) out of 2660 appendicectomies.
    • In 43 cases where appendicectomy was not incidental, 21 were associated with salpingitis and 15 with other intraperitoneal inflammation.
    • Periappendicitis was suspected preoperatively in only 3 of 43 cases, with the appendix appearing normal or inflamed intraoperatively in the remaining cases.

    Conclusions:

    • Periappendicitis is an uncommon but significant microscopic diagnosis following appendicectomy.
    • The condition frequently presents with signs of generalized intraperitoneal inflammation, potentially leading to misdiagnosis.
    • Awareness of periappendicitis is crucial for accurate diagnosis and appropriate patient management in cases of suspected appendicitis.