Clinicopathological observations on incidental appendicectomy in a tertiary care teaching hospital, Ranchi

Authors

  • Krishna Chander Birua Assistant Professor, Department of General Surgery, ICARE Institute of Medical Sciences and Research, Banbishnupur, Purba Medinipur, Haldia 721645, West Bengal, India
  • Manju Boipai Assistant Professor, Department of Microbiology, Hazaribagh Medical College, Hazaribagh 825319, Jharkhand, India
  • R G Baxla Associate Professor, Department of General Surgery, Rajendra Institute of Medical Sciences Bariatu, Ranchi 834009,Jharkhand, India
  • Shashi Dinkar Minj Associate Professor, Department of Anesthesiology, Hazaribagh Medical College, Hazaribagh 825319, Jharkhand, India
  • Rameswari Beck Assistant Professor, Department of Obstetrics & Gynaecology, Hazaribagh Medical College, Hazaribagh 825319, Jharkhand, India
  • R N Singh Professor & Head, Department of General Surgery, Rajendra Institute of Medical Sciences Bariatu, Ranchi 834009,Jharkhand, India

Keywords:

Appendix, appendicitis, abdominal pathologies, laparotomy, incidental appendicectomy, histopathology.

Abstract

Background: Incidental appendectomy is defined as the removal of a clinically normal appendix during non-appendiceal surgery.  This study was conducted at RIMS, Ranchi to document effects of incidental appendicectomy on overall morbidity and mortality while performing the intra-abdominal operation and also to study the frequency of pathological findings in incidentally removed appendices and the correlation between the pathology in the appendix with known aetiological factors for acute appendicitis.

Materials & Methods: The diagnosis of the primary intra-abdominal pathology was made on the basis of a detailed history through clinical examination, supported by laboratory investigations and confirmed during operation besides, the patients. The clinical setting-emergency or elective laparotomy in which the appendix was removed was noted. Laparotomy incision used was noted with regard to the case with which the appendix could be approached. The naked eye examination of the appendix was noted. A piece of appendix was collected for histopathological examination.

Results: About 42% of patients were below 30 years of age. Approximately 68% of female patients were below 40 years of age. Diseases of the extra-hepatic biliary tree were the most frequent indications for operation in female patients (91%).  Contaminated operations formed 88% of abdominal operations. Appendix could be easily approached and removed in 90% of the laparotomies. Operative time (length of anaesthesia) was increased by an average of 7.7 minutes. Retrocaecal position was the commonest site of appendix (68%). Length of appendices varied between 2.5-15 cms, majority being about 5-10 cms in length. Fibrotic changes with luminal obliteration were observed in 15% of appendices. Faecoliths alone or with bands, kings, adhesions or thickening of wall of appendix were present in 12% cases. Evidence of focal or catarrhal appendicitis was evident in 3% cases. Post-operative hospital stay was 12 days or less in the majority of patients (93%).

Conclusion: An incidental appendicectoy should be performed when operating in abdomen for the surgical treatment of some other diseases, where no contraindication exists. The added procedure does not increase either intra-operative risk or post-operative complications and spares the patient from the possible subsequent development of acute appendicitis.

Downloads

Published

2020-07-31

How to Cite

Birua, K. C., Boipai, M., Baxla, R. G., Dinkar Minj, S., Beck, R., & Singh, R. N. (2020). Clinicopathological observations on incidental appendicectomy in a tertiary care teaching hospital, Ranchi. International Journal of Health and Clinical Research, 3(3), 28–35. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/81