Unexpected Histopathological Diagnoses in Appendectomy Specimens: A Retrospective Analysis of 765 Patients At Tertiary Care Hospital

Abstract

Objective: Appendectomy is the most commonly performed abdominal surgery worldwide. In this study, we examined the pathology results of acute appendicitis cases and analyzed unexpected pathology results. Method: We retrospectively analyzed the age, gender, and pathologic diagnoses of patients operated for acute appendicitis between 2020 and 2025 in the Department of General Surgery, Pamukkale University Faculty of Medicine. Results: A total of 765 patients were included in the study. Of these patients, 495 (64.7%) were male and 270 (35.3%) were female, and the mean age of all patients was 38.8 years. Unexpected pathological results were detected in 23 (3%) of the patients who underwent surgery for acute appendicitis. Of the patients with unexpected pathology results, 15 (65.2%) were female and 8 (34.8%) were male. The mean age of patients with unexpected pathological findings was 48.5 years. There was a statistically significant difference in age between the two groups; the average age of the unexpected pathology group was higher than that of the appendectomy group (p = 0.012). Unexpected pathological results included endometriosis in 4 (0.52%) patients, adenocarcinoma in 2 (0.26%) patients, enterobius vermicularis in 1 (0.13%) patient, granulomatous inflammation in 1 (0.13%) patient, low-grade appendiceal mucinous neoplasia (LAMN) in 12 (1.57%) patients, high-grade appendiceal mucinous neoplasia (HAMN) in 1 (0.13%) patient, mucocele in 1 (0.13%) patient, and malignant epithelial tumor metastasis of the breast in 1 (0.13%) patient. Conclusion: The most common cause of acute appendicitis is obstruction of the appendiceal lumen due to lymphoid hyperplasia and fecaloid, but some rare causes of acute appendicitis should be kept in mind. These include parasitic infections, benign and malignant tumors and various incidental pathologies. Patients with an unexpected pathologic diagnosis have the chance to receive the correct treatment according to the results of the pathology reports.

Keywords

• appendicitis
• appendectomy
• unexpected pathology

Apendektomi Spesmenlerinde Beklenmedik Histopatolojik Tanılar: Üçüncü Basamak Hastanede 765 Hastanın Retrospektif Analizi

Abstract

Amaç: Apendektomi, dünya çapında en sık uygulanan abdominal cerrahidir. Bu çalışmada, akut apandisit olgularının patoloji sonuçlarını inceledik ve beklenmedik patoloji sonuçlarını analiz ettik. Yöntem: Pamukkale Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı’nda 2020-2025 yılları arasında akut apandisit nedeniyle opere edilen hastaların yaş, cinsiyet ve patolojik tanıları retrospektif olarak incelendi. Bulgular: Çalışmaya toplam 765 hasta dahil edildi. Bu hastaların 495'i (%64,7) erkek, 270'i (%35,3) kadındı ve tüm hastaların yaş ortalaması 38,8 yıldı. Akut apandisit nedeniyle ameliyat edilen hastaların 23'ünde (%3) beklenmedik patolojik sonuç saptandı. Beklenmeyen patolojik sonuçlanan hastaların 15'i (%65,2) kadın, 8'i (%34,8) erkekti. Beklenmeyen patolojik bulgu saptanan hastaların yaş ortalaması 48,5 yıldı. İki grup arasında yaş açısından istatistiksel olarak anlamlı fark vardı; beklenmeyen patoloji grubunun yaş ortalaması, apendektomi grubundan daha yüksekti (p=0,012). Beklenmeyen patolojik bulgular arasında 4 (%0,52) hastada endometriozis, 2 (%0,26) hastada adenokarsinom, 1 (%0,13) hastada enterobius vermicularis, 1 (%0,13) hastada granülomatöz inflamasyon, 12 (%1,57) hastada düşük dereceli apendiks musinöz neoplazisi (LAMN), 1 (%0,13) hastada yüksek dereceli apendiks musinöz neoplazisi (HAMN), 1 (%0,13) hastada mukosel ve 1 (%0,13) hastada memede malign epitel tümör metastazı vardı. Sonuç: Akut apandisitin en sık nedeni, lenfoid hiperplazi ve fekaloid nedeniyle apendiks lümeninin tıkanmasıdır. Ancak, akut apandisitin bazı nadir nedenleri de akılda tutulmalıdır. Bunlar arasında paraziter enfeksiyonlar, iyi huylu ve kötü huylu tümörler ve çeşitli tesadüfi patolojiler bulunur. Beklenmeyen patolojik tanı alan hastalar, patoloji raporlarının sonuçlarına göre doğru tedaviyi alma şansına sahiptir.

Keywords

• apandisit
• apendektomi
• beklenmedik patoloji

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