Clinical Impact of Incidental Pathological Findings After Appendectomy
DOI:
https://doi.org/10.34635/rpc.1209Keywords:
Appendectomy, Appendicitis/surgery, Appendix/pathology, Incidental FindingsAbstract
Introduction: Routine histopathological examination of appendectomy specimens remains controversial despite its potential to identify clinically significant incidental pathological findings. This study aimed to evaluate the spectrum and clinical significance of incidental pathological findings detected during routine histopathological examination of appendectomy specimens, with particular emphasis on their influence on postoperative management.
Methods: This retrospective single-center observational study included 52 consecutive patients with histologically confirmed acute appendicitis who underwent appendectomy. All specimens underwent routine histopathological examination, with immunohistochemical analysis performed when indicated. Demographic, clinicopathological, and postoperative follow-up data were reviewed to assess the clinical implications of incidental pathological findings.
Results: Incidental pathological findings were identified in 5 of 52 appendectomy specimens (9.6%), including two well-differentiated neuroendocrine tumors, one appendiceal endometriosis, one appendiceal diverticulum, and one Enterobius vermicularis infestation. Histopathological diagnosis resulted in additional postoperative management in all affected patients, including multidisciplinary oncologic evaluation and surveillance, gynecological referral, colonoscopic investigation, or disease-specific anti-helminthic therapy. Immunohistochemical analysis confirmed both neuroendocrine tumors and appendiceal endometriosis.
Conclusion: Although uncommon, incidental pathological findings detected during routine histopathological examination may influence postoperative management. These findings demonstrate the value of histopathological evaluation beyond confirming acute appendicitis and support its consideration as part of comprehensive surgical care.
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