Correlation of macroscopic assesment in acute appendicitis with histopathology findings

ABSTRACT

To assess the observational accuracy for gross appendicular morphology at surgery by comparing it with the microscopic examination results, in order to develop clinical guidelines for improving this assessment especially with the emerging role of diagnostic laparoscopy.Retrospective, descriptive study over a period of one year.Ward 26 of Jinnah Postgraduate Medical Centre, Karachi. All patients admitted with the diagnosis of Acute Appendicitis and were operated upon. Macroscopic assessment of the appendices at operation were divided in four grades. Appendectomies were performed in all the patients and the specimens sent for histopathological examination. The reports were then compared with the gross description.The observational accuracy was 89% as compared to histopathological accuracy which was 96% amongst the total 358 patients suspected of acute appendicitis on clinical grounds. The clinical examination was false positive in 3.6% cases.Careful clinical examination is reliable; observational description of the surgeons can be improved by grading the pathological appearances of the appendix