The Gallbladder and Vermiform Appendix as Quality Assurance Indicators in Autopsy Pathology

We investigate the number of autopsy reports that did or did not document the presence or absence of the gallbladder or appendix or document abdominal scars in patients following cholecystectomy or appendectomy. We also report gallbladder and appendix pathology at autopsy.

Autopsy reports from patients 18 years or older autopsied at a community teaching hospital between January 1, 2009, and December 31, 2018 were reviewed. Nonabdominal autopsies were excluded. Histopathologic examination of the gallbladder and appendix was only performed if gross pathology was seen.

Of the 385 autopsies studied, 48 (12.5%) had cholecystectomies, of which 6 (12.5%) did not document abdominal scars. Sixty-two (16.1%) had appendectomies, of which 12 (19.4%) did not document abdominal scars. The presence or absence of the gallbladder and appendix was not documented in 6 (1.6%) and 16 (4.2%) of reports, respectively. Pathology was seen in 87 (25.8%) gallbladders and 4 (1.2%) appendixes.

Absence of the gallbladder or appendix is a relatively common autopsy finding. Auditing autopsy reports for documentation of their presence or absence, along with associated abdominal scars, are potential quality assurance indicators of autopsy reports. Documentation of these elements could be improved by changing the autopsy template or using synoptic reporting.