APPENDICULAR DISEASES;

Abstract

Acute appendicitis is a common cause of acute surgical abdomen and manyappendectomies are performed daily. All disease processes involving appendix will present asacute appendicitis. Clinically diagnosed acute appendicitis is treated by urgent appendectomy.As most of the removed appendices will reveal acute suppurative inflammation, therefore,appendectomy specimens are not usually submitted for histopathological examination unlessthe surgeon notices advanced disease or grossly recognizable abnormalities. Objectives: Thepurpose of this study is; 1, to explore the spectrum of diseases affecting the appendix in thecommunity; 2, to find the age and gender association of appendicular diseases; and 3, to seeif all the surgically removed appendices should be submitted for histopathological examinationas a routine procedure. Study Design: Retrospective study. Setting: Charsada TeachingHospital affiliated with Jinnah Medical College Peshawar. Period: January 2013 to January2016. Methods: The histology slides and diagnoses of all the retrieved cases were reviewedwith regards to morphology, patient’s age, gender and presence or absence of any associateddisease. Results: Nine disease entities were identified affecting the appendix, which from mostto least common were acute suppurative appendicitis, lymphoid hyperplasia, fecalith, fibrousluminal obliteration, oxyuriasis, carcinoid tumor, submucosal fibrosis, acquired diverticulosis,and inflammatory mucocele. The first three commonest diseases were most frequent in thesecond decade of life; fibrous luminal obliteration in the fourth decade, carcinoid tumors inthe third decade, and oxyuriasis in the first decade. Moreover, acute suppurative appendicitis,fecalith, oxyuriasis, and submucosal fibrosis were more frequent in males; whereas, lymphoidhyperplasia and fibrous luminal obliteration were more common in females. Conclusions:Acute suppurative appendicitis was the most common histological diagnosis. Acute suppurativeappendicitis, fecalith, oxyuriasis, and submucosal fibrosis were more common in males;whereas, lymphoid hyperplasia and fibrous luminal atresia were more common in females.Acute suppurative appendicitis, lymphoid hyperplasia, and fecalith were most common in thesecond decade of life. In view of the nine different histological disease entities identified in thisstudy under one clinical diagnosis of acute appendicitis, it is highly recommended to submit allappendectomy specimens for histopathological examination.