TY - JOUR
T1 - Negative paediatric appendicectomy rates
AU - O’sullivan, D.
AU - Abd Elwahab, S.
AU - Sharkey, C.
AU - Kavanagh, E.
AU - Browne, L.
AU - Lowery, A.
AU - Merrigan, A.
AU - Tormey, S.
N1 - Publisher Copyright:
© 2020, Irish Medical Association. All rights reserved.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Negative appendectomy
KW - Normal appendix
KW - Paediatric appendicitis
UR - http://www.scopus.com/inward/record.url?scp=85098725231&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:85098725231
SN - 0332-3102
VL - 113
SP - 1
JO - Irish Medical Journal
JF - Irish Medical Journal
IS - 9
M1 - P177
ER -