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Category: Volume 07 Issue 10 October 2019
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Title: Unusual Presentation of Appendicitis and a viewing Eosinophilia in Sub acute Appendicitis

Authors: Dr Gayathri M. N, Dr Pavan Kumar M., Dr Apoorva N

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.55

Abstract

  

Background: Vermiform appendix, although a rudimentary structure in humans is one of the frequently encountered specimens in the routine drill of a histopathologist. Acute appendicitis is the most rampant diagnosis that frequently demands an emergency procedure. However, grossly normal- appearing appendix, removed from patients with suspected acute appendicitis, on histopathological examination may harbour a more serious underlying pathology. Therefore it is rationale to examine all the operated specimens.

On the other hand literature shows that appendicitis can be associated with peripheral blood eosinophilia, thereby necessitating complete hemogram, prior to preparation of the patient.

Aims and Objectives

  1. To study the histomorphology of appendicitis specimens with special interest to unusual presentations.
  2. To correlate peripheral blood eosinophilic count in cases of subacute appendicitis.

Materials and Methods: This study was conducted with appendicectomy specimens received to the Department of Histopathology MMC &RI from K.R. hospital. A total of 125 cases were included in the present study that were clinically suspected to be acute or recurrent appendicitis.

Results: In this descriptive study, the records pertaining to 125 appendicectomy specimens, at our tertiary care centre were studied and compared with the available data.

Conclusion:  It is of utmost importance to examine all the appendicectomy specimens so as to not miss on any unusual or coexisting pathology.

Keywords: Appendicitis, Unusual presentation, Eosinophilia, Sub acute appendicitis.

References

  1. Sujatha et al. Histopathological spectrum of appendicectomy specimens - A prospective study. Indian Journal of Pathology and Oncology, October-December 2017;4(4):638-642
  2. Oguntola AS, Adeoti ML, Oyemolade TA. Appendicitis: Trends in incidence, age, sex and seasonal variations in South-western Nigeria. Ann Afr Med 2010;9:213-7.
  3. Fergusson JAE, Hitos K, Simpson E. Utility of white cell count and ultrasound in the diagnosis of acute appendicitis. ANZ J Surg 2002;72:781-5.
  1. Rosai, J., Ackerman, L. V., & Rosai, J. Rosai and Ackerman's surgical pathology. Chapter 16: Edinburgh: Mosby; 2011.p.617-641
  2. O’Connell PR. The vermiform appendix. In: Russell RC, Williams NS, Bulstrode CJ. editors. Bailey and Love’s Short Practice of Surgery.26th ed. London: Arnold Hodder;2010.p.1203-18.
  3. R Vijayaraghavan, R Chandrashekar , C S Belagavi. Inflammatory Myofibroblastic tumour of appendix. J Clin Pathol. 2006 Sep; 59(9): 999-1000
  4. Patil SL, Patil LG, Masane PN, Agrawal PP. Eosinophilia: a case series with review on different clinical presentations of eosinophilia. Int J Adv Med 2015;2:312-6.
  5. Garza-Serna U, Ramos-Mayo A,Lopez-Garnica D, Lopez-Morales J, Diaz-Elizondo J, Flores-Villalba E (2016) Eosinophilic acute appendicitis and intra-abdominal granuloma caused by Enterobius vermicularis in a pediatric patient. Surgical Infections Case Reports 1:1, 103–105, DOI: 10.1089/crsi.2016.0029
  6. Patel et al. Impact of Histopathological Examination of Appendix in Context to Clinical Management of Patients. Annals of Pathology and Laboratory Medicine, Vol. 4, Issue 6, November-December, 2017
  1. Rabindranath D, Khan AA, Ansari H, Senthil P. Unusual incidental findings of routine histopathological examination of appendectomy specimens- a 2-year retrospective analysis with review of the literature. Int J of Allied Med Sci and Clin Res 2016; 4(1):90-98.
  2. Jones AE, Philips AW, Jarvis JR, et al. The value of routine histopathological examination of appendicectomy specimens. BMC Surg 2007;10:7-17.
  1. Chawda HK, Miskin AT, Dombale VD. Spectrum of histopathological lesion in surgically removed appendix, Journal of Drug Discovery and Therapeutics Available. 2015:3;53-56.
  2. R. Ilić, N. M. Stojanović, P. J. Randjelović, et al., Four Cases of Appendiceal Neuroma Mimicking Acute Appendicitis. Facta Universitatis. Series: Medicine and Biology Vol. 17, No 2, 2015, pp. 60-62.
  3. Schmutzer KJ, Bayar M, Zaki AE, Regan JF, Poletti JB. 331.-Tumors of the appendix. Dis Colon Rectum 1975; 18:324
  4. Misdraji J, Graeme-Cook FM. Miscellaneous conditions of the 163.- Semin Diagn Pathol 2004; 21:151
  5. Bonnet J P, Basset T, Dijoux D. Abdominal inflammatory myofibroblastic tumors in children: report of an appendiceal case and review of the literature. J Pediatr Surg1996311311–1314.
  6. Miller G, Wright R. Does subacute appendicits exist?. Pathology. 2010;42:S72.
  7. Berk D, Sylvester K. Subacute Appendicitis. Clinical Pediatrics. 2005;44(4):363-365.

Corresponding Author

Dr Apoorva N

Department of Pathology, Mysore Medical College and Research Institute, Mysuru, Karnataka, India