Pathological Findings of Vermiform Appendix in Surin Hospital

Abstract

Background: Acute appendicitis is the most common caused for acute emergency acute abdominal operation in patients with acute abdominal pain. Frequently, tissue of vermiform appendix is ignored without pathological examination and report.
Objective: To study the pathology of vermiform appendix, determine the rate of acute inflammation, and evaluate the variables that might influence the accuracy of clinical diagnosis of acute appendicitis.
Materials and Methods: All appendectomy specimens during 2004-2008 at Surin Hospital, Surin Province, Thailand were studied. Frequency of various pathological finding, and the association between variables and the accuracy of clinical diagnosis of acute appendicitis were determined.
Results: The studies comprised of 4,300 appendices with clinical suspicion of acute appendicitis. The incidence of inflamed appendices was 73.9% (3,179/4,300 cases). Of these, 1,411 (44.4%) were male and 1,768 (55.6%) were female. The rate of ruptured appendicitis was 11.5% including 218 cases (44.1%) of male and 276 cases (55.9%) of female. Statistical analysis revealed association between the accuracy of clinical diagnosis of acute appendicitis and gender (P = 0.0001). Other pathological finding included 14 cases of parasitic infestation, 66 cases of fibrous obliteration, 3 cases of carcinoid tumor, 11 cases of tuberculosis, 5 cases of mucocele, 2 cases of endometriosis, 1 case of adenocarcinoma, 4 cases of metastatic carcinoma, and so on.
Conclusion: Acute appendicitis is the most common pathologic cause of appendectomy, and various abnormal findings can be found. Pathological examination of the vermiform appendix is necessary in all cases.
Key words: Vermiform appendix, acute appendicitis, carcinoid tumor, adenocarcinoma