P-55 Histopathologic Findings in Clinical Acute Appendicitis: the University Hospital of the West Indies Experience in the Era of Computed Tomography
Author(s):
SG Webster, SE Shirley
Year of Presentation:
2023
Objective: To classify and determine clinicopathological concordance of appendectomy specimens submitted for clinically suspected appendicitis in the era of computed tomography within a Jamaican institution.
Methods: A retrospective review of 1406 Pathology reports, generated during a 10-year period was done. Chi squared and T-tests were used to determine statistical significance where appropriate.
Results: Acute appendicitis was histologically confirmed in 1110 (79%) of 1406 cases; 658 (59%) were complicated, with an overall perforation rate of 5%. Age-specific frequency of complicated appendicitis was greatest in persons within the 7 th decade of life (100%). The overall negative appendectomy rate declined to 21%. The gender-specific negative appendectomy rate was highest in child-bearing women (34%).
Conclusion: A high concordance rate between the clinical and histological diagnoses exists. The overall rate of complicated appendicitis is high; however, the rate of perforated appendicitis is low. Elderly patients with acute appendicitis seem more likely to have a complicated course, as such early diagnosis is critical to decrease mortality and morbidity. Despite the general decline in overall negative appendectomies, the rates remain significantly high, even in the era of increased availability of computed tomography at the University Hospital of the West Indies.