Abstract
BACKGRUND: Acute appendicitis is an important clinical condition that usually occurs as a result of obstruction of the appendix lumen due to fecaloma or reactive lymphoid hyperplasia. However, rarely, various nonspecific and unusual pathologies can cause acute appendicitis or mimic this clinical condition. The aim of this study was to present patients who underwent surgery with a preliminary diagnosis of acute appendicitis and to determine the incidence of incidentally diagnosed nonspecific and unusual pathologies found during histopathological examination of the specimens. METHODS: Data from 2633 patients who underwent appendectomy with a preliminary diagnosis of acute appendicitis in our clinic between January 2014 and June 2023 were retrospectively analyzed. Patients who underwent elective appendectomy in addition to other intra-abdominal operations were excluded. Specimens with unusual diagnoses were re-evaluated histopathologically. The data were analyzed statistically. RESULTS: A total of 2633 patients were included in the study, 1617 (61.4%) male and 1016 (38.6%) female. The mean age was 11.32+-3.66 (range: 1-18) years. All patients underwent the standard appendectomy procedure. After histopathological examination, the specimens were detected to show inflamed appendicitis in 2150 cases (81.65%), perforated appendicitis in 162 cases (6.15%), fibrous obliteration in 104 cases (3.94%) and unusual histopathological findings in 57 cases (2.16%). Of the patients with unusual histopathological findings, 40 were female and 17 were male. Enterobius vermicularis was detected in 41 patients (1.55%), appendicular carcinoid tumor in 10 patients (0.4%) and serous appendicitis in 6 patients (0.2%). Microscopic findings of acute appendicitis were not observed in 35 of these patients. CONCLUSION: Nonspecific and unusual histopathological findings are more common in childhood appendectomy specimens than in those from adults. Careful histopathological evaluation of appendix specimens will allow early diagnosis and treatment of these rarely seen pathologies.