Page 15 - World Journal of Laparoscopic Surgery

Non-appendicitis Pathologies during Appendectomy
The dose of radiation delivered to the patients during CT scan of In this study, histopathology of the removed appendix was done
the abdomen is high, which may be comparable to 400 chest X-rays, for all cases. 131 (90.34%) patients had appendiceal pathology, 130
and this certainly will increase the risk of occurrence of malignancies (89.66%) patients had different types of acute inflammations, and
like leukemia. 8–10 one patient had a low-grade mucinous neoplasm non-infiltrative
In our institution, a CT scan is not routinely used to diagnose with free margins. Fifteen patients had negative appendectomies.
acute appendicitis. The appendix of the patient with cecal diverticulitis showed acute
Acute appendicitis can mimic many gynecologic conditions, catarrhal inflammation. Six patients with negative appendectomy
making the diagnosis uncertain. Although the imaging techniques had another pathology of their acute abdominal pain, which
have improved over the last three decades, it may still be challenging managed laparoscopically. Nine (6%) patients had no apparent
to differentiate between non-gynecologic and gynecologic causes cause of their abdominal pain.
of the acute abdomen before surgery. 11 Appendiceal mucinous neoplasms are rare tumors with an
This retrospective study was done on 145 patients who were incidence of 0.4–1.0% among gastrointestinal cancers. In the early
admitted to the Emergency Unit, Zagazig University Hospitals, stage and due to distension of the appendix with mucin, it presents
Egypt with a diagnosis of acute appendicitis from March 2017 to with acute appendicitis-like symptoms. About one-third of the
December 2019. patients with appendiceal mucinous neoplasms are diagnosed
In this study, the incidence of non-appendicitis acute abdomen preoperatively as acute appendicitis. 23,24
among our patients was 7/145 (4.83%). The gynecological causes The incidence of non-appendicitis pathology in our study was
were 4/145 (2.76%): three ruptured ovarian cysts, and one ovarian 7/145 (4.83%), which was slightly higher than that reported by
torsion. The extra-appendiceal non-gynecological causes were Yabanoglu et al. (3.9%). 4
3/145 (2.07%): one Meckel’s diverticulitis, one cecal diverticulitis,
and one inflamed sigmoid appendices epiploica. conclusIon
Seetahal et al. conducted a retrospective study that revealed
that the gynecologic conditions involving the ovary are the Diagnosis of acute appendicitis is challenging up to date; we faced
commonest to be misdiagnosed as an appendiceal disease in many conditions mimicking acute appendicitis during surgical
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females. Literature depicted the risk of a wrong preoperative intervention.
diagnosis (ovarian causes versus acute appendicitis) to be 5–8%,
which was not high but still worthy of attention. 13 orcId
The clinical presentation of Meckel’s diverticulitis is typically Mohammed Algazar https://orcid.org/0000-0001-7307-8579
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nonspecific. Radiologically, the diagnosis of Meckel’s diverticulitis
can be challenging, especially if it is initially not suspected. 15 references
In this study, one case (0.69%) of complicated gangrenous
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