Background
Many studies have reported on the modalities of diagnosis and management of acute appendicitis globally, but few have addressed if there is a need for ongoing histopathological analysis. Many appendicitis specimens demonstrate acute inflammation, perforation, or necrosis on histology with less than 10% of the appendix showing the probable aetiological agent. There is a worrying increasing trend of appendiceal neoplasms showing an increase in incidence from 5.6% to 12.7% in the adult population but this incidence remains low in the paediatric group at 0.3% (Ranaweera et al, 2019). One appendix specimen analysis costs R1200 (67 US dollars)
Method
Retrospective cross-sectional study involving all paediatric cases of acute appendicitis managed at the three tertiary centres in the region over a 5 year period.
Results
1520 patients were identified post appendectomy. 1(0.06%) had neoplasm of the appendix, 25 (1.6%) had parasitic infestation, 8 (0.5%) normal appendix and the remaining 1486 (97.8%) suppurative appendicitis.
Conclusion
With 98% of the appendix specimens showing suppurative appendicitis and only 0.06% revealing malignancy, a recommendation to not submit further specimens in the paediatric population holds with an estimated saving of 101 840 USD.
Keywords: Histopathology, appendicitis
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