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Międzyleski Szpital Specjalistyczny w Warszawie


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Appendicitis and other pathologies of appendix vermiformis: An analysis based on 11.000 histopathological specimens
Sławomir Poletajew1,2, Marcin Czarniecki1, Michał Duda1, Łukasz Hutnik1,2, Anna Janiszewska2, Katarzyna Kocznur1,2, Tomasz Słodkowski1, Michał Suty2, Anna Woźna1, Ewa Zielińska1
Promotor of study: Ewa Walczak MD1

1Students' Scientific Society at the Department of Pathologic Anatomy, Medical University of Warsaw
Chief: Prof. Aleksander Wasiutyński

2Students' Scientific Society at the Department of General and Vascular Surgery, Miedzyleski Specialist Hospital in Warsaw
Chief: Waldemar Kostewicz Ph MD


The most common indication for an appendectomy is acute appendicitis. In the majority of cases, the initial clinical diagnosis is confirmed by the histopathological examination. Different diseases of the appendix are extremely uncommon, and thus very little has been published on the subject.

Aim
The aim of the study is to determine the frequency and characteristics of the uncommon diseases of the appendix vermiformis in patients who underwent an appendectomy.

Material and methods
A retrospective analysis was done on 10,988 histopathological examinations of the appendix at the archive of the Department of Pathologic Anatomy of Medical University of Warsaw and the Department of General and Vascular Surgery of Miedzyleski Specialist Hospital in Warsaw. This covered specimens taken from 1967-2007, with 5,882 women and 5,017 men. The average age was 28.2.
The analysis was performed with a focus on diagnoses different than acute appendicitis.

Results
In 96% of the cases (n=10,548), the pathologist identified the specimen as acute appendicitis, without any other pathologies surrounding the organ. Among the other illnesses, 3.6% (n=400) were diagnosed as representing an enterobial infection, with women being affected three times more often than men (5.2% vs 1.9%, p<0,05). 60% of this diagnosis was made in the 1960s, while only 3.5% since 2000. 19 cases (0.17%) were diagnosed as being of carcinoid origin, while 9 (0.08%) as adenocarcinoma. From these, 6 (0.05%) were considered as primary tumors. Tuberculosis was noticed as the diagnosis in 6 (0.05%) patients (2 in the 1960s, 3 in the '70s, and one thereafter). Ascaris lumbricoides occurrence in the appendix' lumen was observed in 4 cases (0.04%). Leiomyoma (0.02%), leiomyosarcoma (0.01%), and endometriosis (0.01%) were the other extremely rare cases.

Conclusions
1. The most common cause of an inflammatory process of the appendix is acute appendicitis.
2. An enterobial infection is rare, but it is still the most common alternative cause.
3. It is extremely rare to identify the pathology as carcinoid, cancerous, disseminated tuberculosis, or ascariasis.


PUBLIKACJA PRACY:
niebawem..

PREZENTACJA PRACY:
5th International Scienfitic Congress of Medical Students and Young Doctors. Warsaw, 25-27 April 2008.

NAGRODY:
Grand Prix V Międzynarodowego Kongresu Młodych Medyków
I Nagroda sesji chirurgii ogólnej
I Nagroda Oddziału Warszawskiego Towarzystwa Chirurgów Polskich
I Nagroda specjalna sponsora sesji chirurgii ogólnej