Alternative diagnosis for pain in patients who underwent appendectomies for normal appendices and the incidence of negative appendectomies

Abstract EN

Background and objectives: Some gastrointestinal and genitourinary tract pathologies can simulate clinical features of acute appendicitis; we aim to determine the alternative diagnosis for the pain in which appendicitis was considered, and to find the incidence of negative appendectomies in our practice.

Methods: An observational study, including 558 patients, who underwent an appendectomy at Al Sulaimaniyah Teaching Hospital (STH) from the 2nd of January to the 30th of June 2009.

Only patients who underwent urgent appendectomy and the specimen subjected to tissue examination were included.

Appendices were labeled acutely inflamed when, macroscopically there were injections of mucosa, fibrinous or purulent film, edematous or necrotic changes of the wall and blood or pus on opening the appendix.

Results: Most of the patients were young between 20-40 years age with median age of 22 ±7.7 years.

Other pathologies presented in patients with macroscopically normal appendices, included 35 (6.27%) patients had purulent peritoneal fluids occured in young female with tubo-ovarian infections, 12 (2.15%) patients had mesenteric lymphadenitis and 37 (6.63%) patients had rupture Graafian follicles.

Histologically normal appendix was present in 178 (31.89 %) patients, 61 (10.93%) of them were males and 117 (20.96%) were females.

Conclusion: Normal appendectomies were found in 32 % of the patients, more frequently in young female patients, undergoing early (within 6 hrs since the pain) appendectomy, with the most common alternative diagnosis of tubo-ovarian infections.