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Chronic appendicitis: the process from pre-diagnosis to pathology
B H Kanat1, Ö A Solmaz, P Bozdağ
1Malatya Turgut Özal University Training and Research Hospital, Malatya, Turkey. burhankanat@hotmail.com.
Insights
Diagnosing chronic appendicitis (CA) preoperatively is challenging. This study found that only one of eight suspected CA patients actually had the condition, highlighting diagnostic difficulties.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Chronic appendicitis (CA) is a rare condition with unclear etiology, often presenting as prolonged, less severe abdominal pain.
- Some literature suggests CA may result from partial obstruction of the appendix lumen.
Purpose of the Study:
- To evaluate the diagnostic accuracy of preoperative chronic appendicitis (CA) assessment.
- To determine the incidence of CA in patients undergoing appendectomy.
Main Methods:
- Retrospective analysis of 182 appendectomy patients between August 2018 and March 2020.
- Inclusion criteria focused on patients with suspected chronic appendicitis based on clinical presentation.
Main Results:
- Only 8 patients were suspected of having CA preoperatively.
- Of the 8 suspected patients, only 1 (12.5%) was diagnosed with CA post-pathological examination.
- Other pathological findings included malignancy (25%), reactive lymphoid hyperplasia (37.5%), and peri-appendicitis (12.5%).
Conclusions:
- Pathological examination is definitive for diagnosing chronic appendicitis (CA).
- Preoperative diagnosis of CA is difficult and may not always be feasible.
- Prospective studies are needed to better understand and diagnose CA.
Objective:
Chronic appendicitis (CA) is a rare medical condition. CA is characterized by a less severe and almost continuous abdominal pain. It has a clinical picture lasting longer than 1-2 days and extending over weeks, months, even years. The exact etiology of CA is unclear. Certain resources have reported it as the cause of partial obstruction in the lumen of the appendix.
Patients And Methods:
Our study was carried out with the approval of the Clinical Research Ethics Committee. A retrospective analysis was performed between August 2018 and March 2020.
Results:
It was determined that 207 appendectomies were performed during the retrospective scan period. The data of 182 of these patients could be accessed fully and we could get answers to the criteria we thought. Only 8 of the patients screened were likely to be diagnosed with chronic appendicitis in the preoperative period. CA was found in 1 of the 8 patients (12.5%) who underwent surgery after a preliminary diagnosis of CA. Two patients were reported as malignant (25%), 3 patients (37.5%) as reactive lymphoid hyperplasia, and 1 patient as peri appendicitis (12.5%). Bleeding and congestion were reported in the last patient (12.5%).
Conclusions:
The diagnosis of chronic appendicitis is made by pathological examination. It may not always be possible to consider "chronic appendicitis" as a preliminary diagnosis. This should still be kept in mind. In our opinion, it is a bit difficult to make a preliminary diagnosis of chronic appendicitis and make a surgical decision. We believe that controlled and prospective studies can shed more light on chronic appendicitis.
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