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Incidental appendectomy: frequency of pathologic abnormalities
Abstract:
The incidence of pathologic abnormalities found in the appendix when it is removed incidentally at the time of jejunoileal bypass is reported. Thirty-one per cent of these appendices had significant histopathologic changes. In the authors' opinion these findings support the theory that the appendix may undergo bouts of acute inflammation that are self-limited and that the fibrosis observed in the appendix is a direct sequela of such episodes. In potentially contaminated primary procedures the addition of incidental appendectomy does not increase operative morbidity or mortality.
Insights
Pathologic abnormalities are common in incidentally removed appendices during jejunoileal bypass surgery. These findings suggest self-limiting inflammation and fibrosis are typical appendix sequelae, with incidental appendectomy posing no added surgical risk.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Jejunoileal bypass surgery is a bariatric procedure.
- Incidental appendectomy is sometimes performed during this surgery.
Purpose of the Study:
- To report the incidence of pathologic abnormalities in incidentally removed appendices during jejunoileal bypass.
- To evaluate the safety of incidental appendectomy in potentially contaminated procedures.
Main Methods:
- Histopathologic examination of appendices removed incidentally during jejunoileal bypass.
- Analysis of operative morbidity and mortality data for procedures with and without incidental appendectomy.
Main Results:
- Thirty-one percent of incidentally removed appendices showed significant histopathologic changes.
- Incidental appendectomy did not increase operative morbidity or mortality in potentially contaminated primary procedures.
Conclusions:
- Findings support the theory of self-limited acute inflammation and subsequent fibrosis in the appendix.
- Incidental appendectomy is a safe addition to jejunoileal bypass, even in contaminated cases.