Evaluating the benefit of incidental appendectomy

Background: Surgeons sometimes perform appendectomies during abdominopelvic surgeries for surgical conditions unrelated to the appendix. A retrospective study of the histopathological diagnoses of incidental appendectomy specimens was performed to see the value of this practice. Materials and Methods: Records of incidentally resected appendices submitted to the Histopathology Department of the University of Benin Teaching Hospital from January 2005 to December 2014 were reviewed retrospectively. Results: A total of 129 histopathological reports of incidental appendectomy were retrospectively reviewed; 67 (51.9%) of the patients were male and 62 (48.1%) were female, giving a male­female ratio of about 1.1:1. Fifty­four cases (41.9%) had histologically normal appendices, while 75 cases (58.1%) had various histopathologically demonstrable lesions ranging from acute appendicitis (the most frequent with 27%) to neoplasia (one case of mucinous adenocarcinoma). Conclusion: Significant pathology can be uncovered on histopathological examination of the clinically normal appendix. Incidental appendectomy is thus a useful procedure

Unusual Histological Findings of the Appendix Following Appendectomy; a Ten Year Histopathologic Study

Lesions of the appendix are common. The appendix is however exposed to other uncommon but deleterious lesions which if not detected early and prompt attention given immediately; may result in morbidity and mortality.Materials and methods This was a retrospective study which involved 1171 respondents aged between 2 and 80 years. Demographic data were obtained from the archives of the histopathology department of University of Benin Teaching Hospital. Results were analysed with chi square test and results presented in frequencies tables.Results A total of 1171 samples were analysed out of which 17 were miscellaneous findings. This included 7 diagnosed for chronic granulomatous. Parasitic infestations were observed in only two female and 1 male case respectively and their ages ranged between 21 and 50 years. One case each was seen in Carcinoid; intestinal necrosis; intestinal infarction; chronic HPV; haemorrhagic appendix (which was found in a patient between 70 and 80 year age range).ConclusionsThis study has further emphasised the need for routine histopathologic analysis of all appendices following appendectomies regardless of the macroscopic appearance

Post Operative Miscarriage Following Ruptured Appendix in Pregnancy

Acute appendicitis in pregnancy though rare; is the most common non- obstetric complication warranting emergency laparotomy. Gestational physiological changes make difficult the diagnosis and delay in diagnosis and surgery results in increased complications. We present a-24 year old primiparous lady at 16 weeks of gestation who was referred from a private hospital to the accident and emergency unit of the University of Port Harcourt Teaching Hospital with 6 days history of abdominal pain; fever and vomiting at an ultrasound gestational age of 16 weeks and managed as case of ruptured appendix in pregnancy. She had laparotomy and appendicectomy. Intraoperative findings were purulent peritoneal exudates; ruptured appendix with flakes of necrotic tissues and fecolith. She subsequently had post operative miscarriage 48hours after the surgery which was completed by manual vacuum aspiration. She did remarkably well and was discharged on the 7th post operative day. Delay in diagnosis of appendicitis in pregnancy and surgery correlates to a more advanced disease with an increased risk of appendiceal rupture; which may contribute to increased risk of further complications. Prompt surgical intervention should be performed when acute appendicitis is suspected during pregnancy

Une observation de tuberculose isolee de l'appendice au centre hospitalier et universitaire de Brazzaville

La tuberculose extrapulmonaire est; dans les pays en voie de developpement; de plus en plus frequente avec l'avenement de l'infection au virus de l'immunodeficience humaine (VIH). Les auteurs rapportent l'observation d'un homme de 53 ans immunocompetent ayant presente une tuberculose isolee de l'appendice revelee par une peritonite generalisee. Cette atteinte isolee de l'appendice est la moins frequente parmi les localisations viscerales digestives. Le diagnostic anatomo-pathologique etait fait sur la piece d'appendicectomie immergee dans du formol a 10

Local anaesthesia for appendicectomy: one surgeon's experience

Background: Appendicectomy can be performed under general; regional and local anaesthesia but the anaesthetic risks are least with the later. Where it is appropriate to perform a procedure under local anaesthesia therefore; this method should be readily utilized. This report aims to share one surgeon's experience with local anaesthesia for appendicectomy. Method: A prospective study was carried out at the Mile One Hospital; a private clinic in Port Harcourt; Nigeria. Patients with acute appendicitis admitted for appendicectomy between July 1999 and December 2002 were assessed and recruited into the study based on criteria such as weight less than 70 kg and option for local anaesthesia. Lignocaine (0.5) in a dose of 3-4mg/kg body weight was infiltrated in the line of incision (Lanz) superficially and then into deeper planes. Those who would not tolerate lignocaine alone were sedated with 10mg of diazepam and 30mg of pentazocine. Patients who still would not tolerate the procedure were converted to general anaesthesia with ketamine. The appendix was removed with the stump unburied. Results: Out of 78 patients with acute appendicitis 35 (44.85) were considered suitable for local anaesthesia. Only 31 eventually tolerated the procedure; 7 of these patients requiring sedation. General anaesthesia was resorted to in 4 patients who failed to tolerate local anaesthesia with sedation. Five patients (16.13) developed surgical site infections; 10 (32.26) had nausea intra-operatively while 7 (22.58) had subcutaneous emphysema in the immediate postoperative period. The mean operative time was 39minutes. There was no mortality

Charleston Pouch with in-situ appendix and concealed umbilical stoma

Objectives : To evaluate the functional outcome of the Charleston pouch procedure as a continent catheterizable urinary reservoir using an unaltered in-situ appendix with a triangular skin flap at its umbilical stoma with few modifications to the original technique. Patients and Methods: Between February 1999 and October 2002; 34 patients (31 males and 3 females) were studied at the Urology Department; Assiut University Hospital; Assiut; Egypt. The indications for urinary diversion were radical cystectomy for invasive carcinoma of the bilharzial bladder in 27 males and three females; and incontinent epispadias in four male patients. The age of the patients ranged between 18 and 60 years (mean 48.1 6.1 years). Mean follow up was 30 4.2 months (range 11-40 months). The evaluation during the follow-up period included clinical; laboratory; imaging and urodynamic studies to evaluate the functional outcome. Results: All patients are continent (day and night). No stomal stenosis was recorded. Laboratory investigations were within normal. The upper urinary tract remained unchanged in all patients. Pouchometry revealed that the Charleston pouch is a low-pressure (4 -21 cm H2O) reservoir with a good capacity (average 750 ml). Cancer recurrence was recorded in 3 patients at 12; 27 and 32 months. Conclusions: The Charleston pouch with in-situ appendix is an efficient versatile technique for the creation of a catheterizable continent cutaneous urinary reservoir. The umbilical stoma with triangular skin flap provides excellent cosmetic results