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Pathology:
Royal College of Pathologists of Australasia Pathology Update 2010 Abstracts: GENERAL POSTER DISPLAY

DOES SUBACUTE APPENDICITS EXIST?

Miller, G. C.; Wright, R. G.

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Department of Pathology, Gold Coast Hospital, Queensland, Australia

Aims: To determine whether any measured clinical markers or laboratory investigations can predict the occurrence of subacute appendicitis in appendicectomy specimens.

Methods: A retrospective review of 120 consecutive appendixes submitted for histology was performed. The laboratory investigations, peripheral white cell count and peripheral eosinophilia and the clinical features, length of symptoms, temperature, appearance of appendix and outcome were analysed for appendixes with either a predominant neutrophilic or eosinophilic inflammatory infiltrate.

Results: Analysis showed an eosinophilic inflammatory infiltrate was associated with a higher peripheral eosinophilia (0.12 vs 0.20) which did not reach statistical significance. There was no difference in the white cell count (14.9 vs 10.7), the age of patient (28.7 vs 26.1), temperature (37.0 vs 36.8), length of symptoms (2.0 vs 2.2 days), the macroscopic appearance of the appendix or the clinical outcome. Sixteen appendixes had no inflammation. Only one case demonstrated the presence of parasites.

Conclusions: The results show that based on these laboratory and clinical parameters, the diagnosis of a separate entity of subacute appendicitis cannot be made. An interesting phenomenon was the presence of at least some neutrophils and eosinophils in the inflammatory infiltrate in nearly all appendixes reviewed. Further study is required to determine what the presence of eosinophils in the appendix represents.

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References

1. Aravindan KP. Eosinophils in acute appendicitis: possible significance. Indian J Pathol Microbiol 1997; 40: 491-8.

2. Ojo OS, Udeh SC, Odesanmi WO, et al. Review of the histopathological findings in appendices removed for acute appendicitis in Nigerians. J R Coll Surg Edinb 1991; 36: 245-8.

3. Ciani S, Chuaqui B. Histological features of resolving acute, non-complicated phlegmonous appendicitis. Pathol Res Pract 2000; 196: 89-93.

© 2010 Royal College of Pathologists of Australasia

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