Uncommon causes of acute appendicitis: Retrospective analysis of 6785 histopathological findings in a tertiary center.

BACKGROUND: This study aims to determine the uncommon causes of acute appendicitis in analyzed post appendectomy specimens. METHODS: Histopathology reports of 6785 removed appendices were analyzed retrospectively in order to confirm the uncommon cause of acute appendicitis in single tertiary institution. RESULTS: Unusual cause of acute appendicitis was found in 98 (1.44%) samples (40 female and rest 58 male patients). Neuroen-docrine tumor of the appendix was the most common pathology, followed by serrated adenoma, low-grade appendicular mucinous neoplasm, hyperplastic polyp, and intestinal parasite. In four patients (0.05%), appendicular adenocarcinoma was confirmed with an overall mortality of 75%. Age was significantly higher in uncommon acute appendectomies than in ordinary appendectomies. Survival analysis of unusual appendectomies showed that advanced age is of prognostic importance (Kaplan Meier p<0.0001). There was also a difference in survival between different disease groups in unusual appendectomies, but Cox multifactorial analysis showed that these two factors were not statistically significant. CONCLUSION: Although rare, unusual causes are the etiological factor responsible for acute appendicitis. These reasons should be kept in mind in the older age group and the diagnosis of appendicitis should be made carefully.

Effect of alpha-tocopherol and dose sensitivity on pancreatitis formation in rats with experimental pancreatitis.

BACKGROUND: Acute pancreatitis is an inflammatory disease accompanied by pancreatic inflammation characterized by acinar cell damage and leukocyte infiltration in the tissue. At present, mortality and morbidity rates are high despite the current treatment of pancreatitis; therefore, new studies and treatment studies are needed. In this study, the effects of alpha-tocopherol on different doses of L-arginine-induced experimental acute pancreatitis model were investigated. METHODS: Thirty adult male Sprague-Dawley albino rats were randomly divided into four groups; control (sham) group (n=6), acute pancreatitis group (n=8), low-dose alpha-tocopherol (200 mg/kg once intraperitoneal [IP]) group (n=8), and high dose alpha-tocopherol (400 mg/kg once ip) group (n=8). Experimental acute pancreatitis model was created by a single IP dose of 5 g/kg of L-arginine. Alpha-tocopherol was administered in a single dose intraperitoneally, 30 min before the creation of the experimental model of acute pancreatitis induced by L-arginine induction in Groups 3 and 4. Tissue and blood samples were taken under anesthesia 72 h after L-arginine injection; then the rats were sacrificed by decapitation. Serum amylase, lipase, interleukin (IL)-1ß, IL-6, tumor necrosis factor (TNF)-alpha, and C-reactive protein (CRP) levels were examined. Pancreatic tissue samples were examined under a light microscope for histopathological examination. RESULTS: When the acute pancreatitis group (Group 2) was compared to the control group (Group 1), serum amylase, lipase, IL-1ß, IL-6, TNF-alpha, and CRP levels were all significantly increased (p<0.05 for all). Histopathological examination showed significant difference in edema (p<0.001) and inflammation (p=0.007) scores. When the low (Group 3) and high (Group 4) dose alpha-tocopherol groups were compared to Group 2, amylase, lipase, IL-1ß, IL-6, TNF-alpha, and CRP parameters were statistically significantly lower (p<0.05 for all). In the histopathological comparison of Groups 2, 3, and 4, edema and inflammation scores were decreased in Groups 3 and 4 compared to Group 2. Comparing Group 4 to Group 3, lipase (p<0.01), IL-6 (p=0.038), and TNF-alpha (p=0.002) levels were significantly decreased; no significant difference was observed in the histopathological evaluation. CONCLUSION: Alpha-tocopherol was found to reduce inflammation and pancreatic damage in acute pancreatitis and was more effective in high doses.