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The Histopathology of the Appendix in Children at Interval Appendectomy

Whilst most surgeons agree that conservative treatment of appendiceal abscess in children is an adequate treatment, the need for subsequent interval appendectomy is still controversial. We analyzed the histopathology in interval appendectomy in search of signs of inflammation. All patients admitted...

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Autores principales: Pederiva, Federica, Bussani, Rossana, Shafiei, Vennus, Codrich, Daniela, Guida, Edoardo, Schleef, Jurgen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466409/
https://www.ncbi.nlm.nih.gov/pubmed/34572243
http://dx.doi.org/10.3390/children8090811
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author Pederiva, Federica
Bussani, Rossana
Shafiei, Vennus
Codrich, Daniela
Guida, Edoardo
Schleef, Jurgen
author_facet Pederiva, Federica
Bussani, Rossana
Shafiei, Vennus
Codrich, Daniela
Guida, Edoardo
Schleef, Jurgen
author_sort Pederiva, Federica
collection PubMed
description Whilst most surgeons agree that conservative treatment of appendiceal abscess in children is an adequate treatment, the need for subsequent interval appendectomy is still controversial. We analyzed the histopathology in interval appendectomy in search of signs of inflammation. All patients admitted between 2010 and 2017 with appendiceal abscess and scheduled for interval appendectomy were reviewed. The specimens were evaluated for grade of inflammation, type and distribution of cellular infiltrate, presence of necrosis or hemorrhage and infiltrate in the serosa. Forty-two patients had appendiceal abscess and were treated conservatively. Seven underwent emergent appendectomy. Thirty-three out of 35 patients underwent elective interval appendectomy. Thirty-two specimens were revised. Carcinoid tumor or other malignant lesions were not found. All of them presented some amount of inflammation, grade 1 to 2 in 53%, grade 3 to 4 in 47%. Twenty-five percent of the specimens had signs of necrosis accompanied by hemorrhage and in more than the half (53%) the infiltrate extended to the serosa. Conclusions: Although the appendix was mostly found not macroscopically inflamed intraoperatively, histology confirmed a certain grade of inflammation even months after the conservative treatment. No correlation was found between histopathologic findings and lapse of time between abscess treatment and interval appendectomy.
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spelling pubmed-84664092021-09-27 The Histopathology of the Appendix in Children at Interval Appendectomy Pederiva, Federica Bussani, Rossana Shafiei, Vennus Codrich, Daniela Guida, Edoardo Schleef, Jurgen Children (Basel) Article Whilst most surgeons agree that conservative treatment of appendiceal abscess in children is an adequate treatment, the need for subsequent interval appendectomy is still controversial. We analyzed the histopathology in interval appendectomy in search of signs of inflammation. All patients admitted between 2010 and 2017 with appendiceal abscess and scheduled for interval appendectomy were reviewed. The specimens were evaluated for grade of inflammation, type and distribution of cellular infiltrate, presence of necrosis or hemorrhage and infiltrate in the serosa. Forty-two patients had appendiceal abscess and were treated conservatively. Seven underwent emergent appendectomy. Thirty-three out of 35 patients underwent elective interval appendectomy. Thirty-two specimens were revised. Carcinoid tumor or other malignant lesions were not found. All of them presented some amount of inflammation, grade 1 to 2 in 53%, grade 3 to 4 in 47%. Twenty-five percent of the specimens had signs of necrosis accompanied by hemorrhage and in more than the half (53%) the infiltrate extended to the serosa. Conclusions: Although the appendix was mostly found not macroscopically inflamed intraoperatively, histology confirmed a certain grade of inflammation even months after the conservative treatment. No correlation was found between histopathologic findings and lapse of time between abscess treatment and interval appendectomy. MDPI 2021-09-16 /pmc/articles/PMC8466409/ /pubmed/34572243 http://dx.doi.org/10.3390/children8090811 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pederiva, Federica
Bussani, Rossana
Shafiei, Vennus
Codrich, Daniela
Guida, Edoardo
Schleef, Jurgen
The Histopathology of the Appendix in Children at Interval Appendectomy
title The Histopathology of the Appendix in Children at Interval Appendectomy
title_full The Histopathology of the Appendix in Children at Interval Appendectomy
title_fullStr The Histopathology of the Appendix in Children at Interval Appendectomy
title_full_unstemmed The Histopathology of the Appendix in Children at Interval Appendectomy
title_short The Histopathology of the Appendix in Children at Interval Appendectomy
title_sort histopathology of the appendix in children at interval appendectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466409/
https://www.ncbi.nlm.nih.gov/pubmed/34572243
http://dx.doi.org/10.3390/children8090811
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