Negative paediatric appendicectomy rates

D. O’sullivan, S. Abd Elwahab, C. Sharkey, E. Kavanagh, L. Browne, A. Lowery, A. Merrigan, S. Tormey

Research output: Contribution to journalArticlepeer-review

Abstract

Aim To assess the local paediatric negative appendectomy rates at University Hospital Limerick (UHL) with regard to age, gender, histological diagnosis, biochemistry and radiology. Methods A retrospective audit was undertaken to examine the histological, radiological and bicohemical records of paediatric appendectomies at UHL from 2010 to 2016. Negative appendectomy was defined as the removal of an appendix without any signs of histological inflammation (transmural acute inflammation). Results The local negative appendectomy rate at UHL was 31.9% (n=423/1325). The true negative appendectomy (TNA) rate was 6.6% (n=87/1325). We found that the non-inflamed appendix with other pathology subgroup (AWOP) was 25.4% (n=336). Other pathologies were found within the inflamed appendices; fecolith in 25.1% (n=226); lymphoid hyperplasia (LH) in 4.4% (n=40); enterobius in 2.3% (n=21) and carcinoid in 0.2% (n=2). Regarding the AWOP group specifically, the other pathologies identified were; fecolith in 55.7% (n=187), LH in 55.7% (n=187), enterobius in 24.1% (n=81) and carcinoid in 0.3% (n=1). The ultrasound scan (US) rate was 22.7% (n=301), which was inconclusive in 80.7% (n=243) and diagnostic in 18.3% (n=55). Conclusion Despite a high rate of NA, other pathologies were encountered which might explain RIF pain. We propose more specific definitions for negative appendectomy and highlight the need for a standardised approach to pathology and ultrasonography reporting.

Original languageEnglish
Article numberP177
Pages (from-to)1
Number of pages1
JournalIrish Medical Journal
Volume113
Issue number9
Publication statusPublished - 2020
Externally publishedYes

Keywords

  • Negative appendectomy
  • Normal appendix
  • Paediatric appendicitis

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