Unexpected Appendiceal Pathologies and Their Changes With the Expanding Use of Preoperative Imaging Studies
Annals of Coloproctology
; : 99-105, 2017.
Article
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| WPRIM
| ID: wpr-153465
Biblioteca responsable:
WPRO
ABSTRACT
PURPOSE: The preoperative diagnosis of acute appendicitis is often challenging. Sometimes, pathologic results of the appendix embarrass or confuse surgeons. Therefore, more and more imaging studies are being performed to increase the accuracy of appendicitis diagnoses preoperatively. However, data on the effect of this increase in preoperative imaging studies on diagnostic accuracy are limited. We performed this study to explore unexpected appendiceal pathologies and to delineate the role of preoperative imaging studies in the diagnosis of acute appendicitis. METHODS: The medical records of 4,673 patients who underwent an appendectomy for assumed appendicitis between 1997 and 2012 were reviewed retrospectively. Pathological results and preoperative imaging studies were surveyed, and the frequencies of pathological results and preoperative imaging studies were investigated. RESULTS: The overall rate of pathology compatible with acute appendicitis was 84.4%. Unexpected pathological findings, such as normal histology, specific inflammations other than acute appendicitis, neoplastic lesions, and other pathologies, comprised 9.6%, 3.3%, 1.2%, and 1.5%, respectively. The rate of unexpected pathological results was significantly reduced because of the increase in preoperative imaging studies. The decrease in normal appendices contributed the most to the reduction while other unexpected pathologies did not change significantly despite the increased use of imaging studies. This decrease in normal appendices was significant in both male and female patients under the age of 60 years, but the differences in females were more prominent. CONCLUSION: Unexpected appendiceal pathologies comprised 15.6% of the cases. Preoperative imaging studies reduced them by decreasing the negative appendectomy rate of patients with normal appendices.
Palabras clave
Texto completo:
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Base de datos:
WPRIM
Asunto principal:
Patología
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Apendicectomía
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Apendicitis
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Apéndice
/
Registros Médicos
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Estudios Retrospectivos
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Diagnóstico
/
Cirujanos
/
Inflamación
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Annals of Coloproctology
Año:
2017
Tipo del documento:
Article