HISTOPATHOLOGY OF ACUTE APPENDICITIS IN CHILDREN IN ZARIA.

Abstract

Introduction: Appendicitis is a common cause of acute abdomen. Although many guidelines exist to aid in the preoperative diagnosis of appendicitis in children, histology remains the definitive diagnostic method. Histological diagnosis is premised on the presence of inflammatory infiltrates beyond the mucosa and involving the submucosa and muscularis propria. Involvement of the serosa is often associated with peritonitis. Appendices with no pathology have uncommonly been reported with the clinical diagnosis of appendicitis.

Objective: We present the pathological features of appendicitis in 32 children over two years.

Methods: Pathology Department records of consecutive appendectomies in children were retrieved over two years. The gross descriptions were documented and histological assessment of the H&E stained slides was done. Notes were made on the appendix length, obvious gross abnormalities and perforation; histological presence of mucosal lymphoid hyperplasia and ulceration, predominant inflammatory cell type, presence of reparative changes in the submucosa, and involvement of the peritoneum. Appendectomy performed as an addition to other therapies were excluded.

Result: Thirty-two children had appendectomies for acute appendicitis, their ages ranged from 4 months to 17 years (median 14.5 years) and there were 12 females (37.5%) and 20 males (62.5%). Appendicitis could be grouped into simple (acute appendicitis without perforation, suppuration, or peritonitis) 11 (34.4%), complicated (acute appendicitis with perforation, gangrene, and/or suppuration) 14 (43.7%), subacute/ chronic (acute appendicitis with reparative changes or non-specific chronic inflammation) 7 (21.9%). All cases had associated mucosal lymphoid hyperplasia. No negative appendix was seen.

Conclusion: Appendicitis in children is often complicated before surgical intervention.