EVALUATION OF APPENDICECTOMY SPECIMENS FOR NEGATIVE APPENDICECTOMY AT JAWAHARLAL NEHRU INSTITUTE OF MEDICAL SCIENCES HOSPITAL, IMPHAL, INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 18
Abstract
BACKGROUND Acute appendicitis is the most common intra-abdominal condition requiring emergency surgery. Past reports have shown that up to 30% of appendices have been removed after clinical diagnosis of acute appendicitis, which may be normal on histopathological examination. In spite of advanced technology and vast knowledge about the condition, it remains a difficult task for clinicians to diagnose it cent percent accurately. Emergency appendicectomy is performed to prevent morbidity and mortality due to perforation and gangrenous changes. In such situations, a certain percentage of normal appendices are found to be removed due to misdiagnosis. There is general agreement that highly competent surgeons make false positive diagnosis of acute appendicitis and remove normal appendices about 20% to 25%. The discomfort and risks associated with an exploratory laparotomy and discovering “no disease” are far outweighed by the morbidity and mortality (about 2%) associated with perforation (Singhal R et al, 2007). 1 MATERIALS AND METHODS This study was a prospective study conducted in Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India from April 2010 to March 2017. 1000 cases of appendicectomy specimens were examined histopathologically to confirm for acute appendicitis. Detailed history was taken, physical examination and relevant laboratory investigations were performed during the clinical encounter. The diagnosis of acute appendicitis was made clinically and was confirmed after histopathological examination of the removed appendix. RESULTS Out of 1000 appendix specimens sent for histopathological examination, 440 (44%) showed simple appendicitis, 240 (24%) showed gangrenous appendicitis, 200 (20%) showed perforated appendicitis and 120 (12%) showed no appendicitis. CONCLUSION The diagnosis of acute appendicitis is based on clinical evaluation. Laboratory tests and imaging techniques add very little to the diagnosis. A definite diagnosis can be obtained only at surgery and after histopathological examination of the removed appendix. In children and elderly persons, the diagnosis should be made at the earliest and appendicectomy should be performed without delay to reduce the rate of perforation and gangrenous changes of the appendix.
Authors and Affiliations
Yengkhom Sanatomba Singh, Rosemary Vumkhoching, Ningombam Jitendra, Khumallambam Ibomcha Singh
Keywords
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- EP ID EP417278
- DOI 10.14260/jemds/2018/498
- Views 66
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