Histological analysis and revisiting the diagnostic accuracy of acute appendicitis

A retrospective study conducted at a tertiary-care hospital in Sri Lanka analyzed 429 appendectomy samples from patients suspected of acute appendicitis. The mean age was 21 years; 58% were male. Intraoperatively, 80.4% had acute appendicitis, mass formation (2.1%) and rupture (0.4%). Histology showed lymphoid hyperplasia(58.7%),    suppurative appendicitis(8.6%), granulomatous changes [tuberculosis (2.3%), Crohn's(0.7%)], and neoplasms [mucinous dysplasia(3%), carcinoid(0.5%)]. Malignant or premalignant lesions showed no age or gender specificity and were not always evident during surgery. The 12% negative appendectomy rate highlights the need to revise diagnostic criteria.