221 © 2003 Indian Journal of Surgery www.indianjsurg.com Indian Journal of Surgery 2004 Volume 66 Issue 4 (August) Unusual findings in appendectomy specimens: Evaluation of 2458 cases and review of the literature Arife Polat Duzgun, Münevver Moran, Selçuk Uzun, Mahir M. Ozmen, Vasfi M. Ozer, Selda Seckin*, Faruk Coskun Department of Surgery and *Department of Pathology, Ankara Numune Teaching and Research Hospital, Ankara-Turkey. ABSTRACT Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Obstruction of the lumen is the dominant factor for acute appendicitis. Although fecaliths are the usual cause of obstruction, some unusual factors could be the reason. Aim: Our aim was to document the unusual findings in appendectomy specimens. Methods and Material: The hospital records of 2458 patients (834 F) who were diagnosed as acute appendicitis and underwent open appendicectomy during last six years were retrospective according to age, sex, histopathological diagnosis, coexisting pathologies and unusual findings on histology. Statistical Analyses: All data were stored using SPSS 9.05 for Windows. Frequency and distrubution of data were analysed. Results: Unusual findings were determined in 19 (0.7%) cases by histology. Parasites were found in six (0.3%) (Enterobius Vermicularis, Balantidum Coli, Schistosoma Haematobium), mucocele in 5 (0.2%), carcinoid tumour in three (0.1%), B cell malignant lymphoma in one (0.05%), leiomyoma in one (0.05%), primary appendiceal adenocarcinoma in one (0.05%), acute appendicitis with dysplastic changes in one (0.05%) and inflammatory bowel polyp was reported in remaining one case (0.05%). Conclusion: Although unusual or coexisting pathologies can be seen rarely during appendectomy, this should be kept in mind and meticulous exploration and evaluation should be performed in each cases. KEY WORDS Histology, unusual findings, acute appendicitis, appendicectomy, surgery. How to cite this article: Duzgun AP, Moran M, Uzun S, Ozmen MM, Ozer VM, Seckin S, Coskun F. Unusual findings in appendectomy specimens: Evaluation of 2458 cases and review of the literature. Indian J Surg 2004;66:221-6. Original Article Address for correspondence: M. Mahir Ozmen, Turan Günes Bulvari 43.Sokak 9/22, 06450 Oran, E-mail:mmahir@mynet.com Paper Received: March 2004. Paper Accepted: August 2004. Source of Support: Nil. © 2004 Indian Journal of Surgery www.indianjsurg.com INTRODUCTION Acute appendicitis is the most common acute surgical condition of the abdomen. The incidence of acute appendicitis roughly parallels to that of lymphoid development, with the peak incidence in late teens and twenties. The sex ratio in acute appendicitis is about 1:1 prior to puberty. At puberty, male to female ratio becomes 2:1. Obstruction of the lumen is the dominant factor for acute appendicitis. Although fecoliths are the usual cause of obstruction, some unusual factors could also be the reason. This may be due to lymphoid hyperplasia, intestinal worms, malignant or benign tumors, or other conditions. 1 Eventhough, there are many case reports in the English written medical literature, reports with meticulous analyses of all cases with appendicitis are small in number. 2-6 Therefore, this retrospective study was planned to document the unusual findings in appendectomy specimens. MATERIALS AND METHODS Hospital records of 2458 patients (834 females), mean (range) age of 27 (4-85), years who were diagnosed as acute appendicitis and underwent open appendicectomy during last six years (January 1998