The investigation of appendiceal size and volume in pediatric appendectomy specimens in terms of histopathological diagnosis, seasonal variability, age, and gender

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Aim: Acute appendicitis is a common condition mostly in children with unclear etiology that is treated with an emergency appendectomy. However, some unexpected diagnoses called as “negative appendectomy” that do not require treatment may be detected histopathologically. In this study, it was aimed to investigate the histopathologic diagnoses of pediatric appendectomy specimens, considering the macroscopic dimensions and volume of the specimens for the first time in the literature and comparing them with age and gender groups, and seasons of the operations to achieve additional data in preventing negative appendectomy. Material and Method: A total of 122 cases were included in this study. The length, longest diameter, and shortest diameter, as well as the volume of each specimen, were measured during the macroscopic examination. The specimens were evaluated for histopathologic diagnosis according to age, gender, and the season in which the operation was performed. Results: The male-to-female ratio was 1.2. Histopathologically, there were 81 (74.6%) inflammatory [mainly acute appendicitis (65.5%)], and 31 (25.4%) non-inflammatory diseases [mainly lymphoid hyperplasia (21.3%)] that were considered negative appendectomy. Inflammatory diseases were operated mostly in winter (p=0.0099), while non-inflammatory diseases were operated mainly in autumn (p=0.0099). The length, longest diameter (y), and appendiceal volume were significantly greater in inflammatory than in non-inflammatory ones (p=0.0006, p=0.0126, and p=0.0016, respectively). Length and volume were more significant in acute appendicitis than in lymphoid hyperplasia (p=0.0124 and p=0.0358, respectively). In patients ≤12 years, lymphoid hyperplasia was more common in females than in males (p<0.001). In patients >12 years, acute appendicitis was more common in females than males (p<0.034). Conclusion: In this study, histopathological diagnoses observed in appendectomy specimens were evaluated for the first time in the literature according to macroscopic appendix size and volume, as well as age, gender, and seasonal variations. The obtained data have the potential to provide additional information to the literature regarding epidemiological, appropriate preoperative, and pathological approaches

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