title: Histopathological findings in appendectomy specimens: a study of 24,697 cases.
abstract: OBJECTIVE
  Appendicitis is by far the commonest major emergency general surgical operation. Histopathological examination of the appendix is routinely performed.
  
  
  METHODS
  This study is a retrospective analysis of 24,697 appendectomies performed from January 2003 to December 2011. Pathological reports were analyzed for the following parameters: age, gender, and pathological diagnosis.
  
  
  RESULTS
  Appendectomy specimens represent 17 % of all pathological reports. Acute appendicitis was present in 19,637 (79.5 %) patients. The perforation rate was 6.3 % and was significantly higher in adult patients. The negative appendectomy rate was 15 % and was significantly higher in female and adult patients. The incidence of negative appendectomies had clearly decreased over the 9-year period distribution. Incidental unexpected pathological diagnoses were noted in 226 (0.9 %) appendectomy specimens. Neoplastic lesions were present in 171 cases (0.7 %); they include carcinoid, adenocarcinoma, and mucinous neoplasms.
  
  
  CONCLUSIONS
  Routine pathological examination of appendectomy specimens is expensive. With advances in technology and imaging modalities, the diagnosis of acute appendicitis has improved, with a subsequent significant reduction in negative appendectomy. There are still a number of unusual diagnoses found in appendicectomy specimens supporting the continued use of routine histology.
authors.affiliation: Department of Pathology, CHU Habib Bourguiba, Sfax, Tunisia, charfislim@gmail.com.
authors.forename: Slim
authors.initials: S
authors.lastname: Charfi
authors.forename: Ahmad
authors.initials: A
authors.lastname: Sellami
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Affes
authors.forename: Khalil
authors.initials: K
authors.lastname: Yaïch
authors.forename: Rafik
authors.initials: R
authors.lastname: Mzali
authors.forename: Tahya Sellami
authors.initials: TS
authors.lastname: Boudawara
mesh_terms: D000328:Adult; D000367:Age Factors; D001062:Appendectomy; D001065:Appendix / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male