Appendicitis: Difference between revisions

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{{Top
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|author1=[[User:Mikael Häggström|Mikael Häggström]]
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Appendicitis may histopathologically be defined as neutrophilic infiltrates of the wall of the appendix in the correct clinical context.
Appendicitis may histopathologically be defined as neutrophilic infiltrates of the wall of the appendix in the correct clinical context.
{{Fixation - general notes}}
{{Fixation - general notes}}
{{Comprehensiveness}}
<noinclude>{{Comprehensiveness}}</noinclude>


==Gross processing==
==Gross processing==
[[File:Acute Appendicitis.jpg|thumb|Acute suppurative appendicitis: The organ is enlarged and sausage-like (botuliform). This longitudinal section shows red inflamed mucosa with an irregular luminal surface. It was removed early in the disease, with no late complications like transmural necrosis, perforation, and abscess formation.]]
Standard sections if the appendix appears inflamed and there are no signs of malignancy. Describe abnormal signs including:
Standard sections if the appendix appears inflamed and there are no signs of malignancy.
<gallery mode=packed>
File:Gross pathology of congested appendicitis.jpg|thumb|Appendicitis with '''congestion'''
File:Gross pathology of appendicitis with a patchy purulent exudate, annotated.jpg|Serosa with a '''patchy purulent exudate'''.
File:Gross pathology of appendicitis containing a blood-tinged purulent exudate.jpg|Appendicitis, with the lumen containing a '''blood-tinged purulent exudate'''.
File:Acute Appendicitis.jpg|Longitudinal section showing a '''red inflamed mucosa''' with an '''irregular luminal surface''' (in a case of acute suppurative appendicitis).
</gallery>
{{Further|Appendix}}
{{Further|Appendix}}


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*Purple, green or black color
*Purple, green or black color
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*'''Transmural''' inflammation
*'''Transmural''' inflammation, obliterating normal histological structures
*'''Necrotic''' areas
*'''Necrotic''' areas
*Extensive mucosal '''ulceration'''
*Extensive mucosal '''ulceration'''
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| [[File:Histopathology of necrotizing appendicitis, high magnification.jpg|190px]]
| Will '''perforate''' if untreated
| Will '''perforate''' if untreated
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*Predominantly '''mononuclear''' infiltrate rather than neutrophilic.
*Predominantly '''mononuclear''' infiltrate rather than neutrophilic.
| [[File:Histopathology of chronic appendicitis - high magnification.jpg|190px]]
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| Should preferably correlate with '''long-term or recurrent''' symptoms.
| Should preferably correlate with '''long-term or recurrent''' symptoms.
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===Further workup===
{{Moderate-begin}}In acute suppurative appendicitis, still look for any periappendicitis. Also look by the lumen for parasites.{{Moderate-end}}


===Microscopy report===
===Microscopy report===
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;Example:
;Example:
{|class=wikitable
{|class=wikitable
| Acute appendicitis and periappendicitis with transmural necrosis
| {{Moderate-begin}}Appendix, resection (or appendectomy):{{Moderate-end}}<br>Acute {{Moderate-begin}}suppurative{{Moderate-end}} appendicitis {{Moderate-begin}}and periappendicitis{{Moderate-end}} with transmural necrosis and perforation.
|}


{{Bottom}}
{|class=wikitable
| Example AI prompt:<br>neuts across wall to meso and serosa, no perf. make report (copy-paste gross description)
|}
<noinclude>{{Bottom}}</noinclude>
Retrieved from "https://patholines.org/Appendicitis"