Ekrem Çakar1, Savaş Bayrak1, Şükrü Çolak1, Fatih Dal2,3, Bünyamin Gürbulak1, Hasan Bektaş1, Enver Yarıkkaya4, Ayşe Gül Ferlengez5. 1. Department of General Surgery, Health Sciences University Turkish Ministry of Health İstanbul Research and Training Hospital, İstanbul, Turkey. 2. Department of General Surgery, Health Sciences University Turkish Ministry of Health İstanbul Research and Training Hospital, İstanbul, Turkey. fatihdal07@gmail.com. 3. , Istanbul, Turkey. fatihdal07@gmail.com. 4. Department of Pathology, Health Sciences University Turkish Ministry of Health İstanbul Research and Training Hospital, İstanbul, Turkey. 5. Department of Anaesthesiology, Health Sciences University Turkish Ministry of Health İstanbul Research and Training Hospital, İstanbul, Turkey.
Abstract
BACKGROUND: Appendiceal diverticular disease (ADD) is a rare pathology which is associated with an increased mortality risk due to rapid perforation and high rates of neoplasm. In our study, we aimed to evaluate the clinical and histopathological characteristics of ADD with differences from acute appendicitis (AA) diagnosis and to determine the association with neoformative processes. METHODS: The 4279 patients who underwent appendectomy were evaluated retrospectively. ADD patients histopathologically classified into four groups. Patients' demographic characteristics, imaging and preoperative laboratory findings, additionally postoperative histopathology results were compared between groups. RESULTS: The prevalence of ADD was 2.29% (n = 98). In addition, the male/female ratio was 2.37 in ADD patients who were found to be significantly older than those with AA patients. Type III was the most frequently (62.2%) identified sub-group of ADD. The incidence of neoplasms, plastrone, and Littre's hernia was found statistically higher in ADD group than AA group. Mucinous adenomas (10.2%) was the most common neoplasm while the carcinoid tumor (1%) and precancerous serrated adenomas (4.1%) were also reported. CONCLUSIONS: As a result, high neoplasm in ADD patients can be shown with incidence of perforation and plastron, and in order to avoid possible neoplasm or major complications, it is necessary to carry out new studies for the right diagnosis of ADD whether the diagnosis is done preoperatively or ıntraoperatively. We recommend surgical resection of the ADD, which may even be incidentally detected during any surgical procedure, due to its high risk of neoplasm and rapid perforation.
BACKGROUND:Appendiceal diverticular disease (ADD) is a rare pathology which is associated with an increased mortality risk due to rapid perforation and high rates of neoplasm. In our study, we aimed to evaluate the clinical and histopathological characteristics of ADD with differences from acute appendicitis (AA) diagnosis and to determine the association with neoformative processes. METHODS: The 4279 patients who underwent appendectomy were evaluated retrospectively. ADDpatients histopathologically classified into four groups. Patients' demographic characteristics, imaging and preoperative laboratory findings, additionally postoperative histopathology results were compared between groups. RESULTS: The prevalence of ADD was 2.29% (n = 98). In addition, the male/female ratio was 2.37 in ADDpatients who were found to be significantly older than those with AA patients. Type III was the most frequently (62.2%) identified sub-group of ADD. The incidence of neoplasms, plastrone, and Littre's hernia was found statistically higher in ADD group than AA group. Mucinous adenomas (10.2%) was the most common neoplasm while the carcinoid tumor (1%) and precancerous serrated adenomas (4.1%) were also reported. CONCLUSIONS: As a result, high neoplasm in ADDpatients can be shown with incidence of perforation and plastron, and in order to avoid possible neoplasm or major complications, it is necessary to carry out new studies for the right diagnosis of ADD whether the diagnosis is done preoperatively or ıntraoperatively. We recommend surgical resection of the ADD, which may even be incidentally detected during any surgical procedure, due to its high risk of neoplasm and rapid perforation.