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New Emirates Medical Journal

Volume 2, 2 Issues, 2021
ISSN: 0250-6882 (Online)
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Open Access Article

Diverticular Disease of the Vermiform Appendix - Is it a Distinctive Clinico-Pathological Entity?Alternate Title: Diverticular Disease of the Appendix



Offir Ben-Ishay1, *, Narmeen Abdalqader2, Yaniv Zohar2, Yoram Kluger1
1 Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
2 Institute of Pathology, Rambam Health Care Campus, Haifa, Israel

Abstract

Background:

Diverticular disease of the appendix [DDOA] is a rare occurrence. Although acquired in nature, its impact on the disease process of appendicitis is not well-defined. The purpose of the current study is to include a comprehensive clinico-pathological definition of the disease through a retrospective single-center cohort analysis with a prospective pathological re-evaluation.

Methods:

A retrospective analysis of post-appendectomy patients over a period of 16 years [2000-2015] was carried out. Patients with DDOA were identified and compared to a control group of patients with acute appendicitis. Histology was re-evaluated prospectively by a senior pathologist. Primary measures of the outcome included clinical and surgical differences. Pathological macroscopic differences between the two groups and a comprehensive description of the DDOA itself were performed.

Results:

6846 post appendectomy patients were operated on during the study period, and 127 [1.9%] were diagnosed with DDOA. The DDOA group showed significantly higher age, longer duration of complaints, and a different clinical presentation. Operative time was significantly longer in the study group and had higher rates of severe postoperative complications such as postoperative bleeding, need for ICU recovery, and need for postoperative mechanical ventilation. All diverticula were pseudo-diverticula and were significantly shorter and wider. Multivariate analysis showed that age, length, and width of the appendix were independently associated with DDOA.

Conclusion:

The results of this study suggest that DDOA is an independent clinical entity, showing differences in etiology, clinical presentation, and postoperative outcome. Prospective studies are needed to assess whether the preoperative diagnosis is feasible and will change conventional surgical management.

Keywords: Diverticula, Appendix, Diverticulitis, Pathology, DDOA, Etiology.


Article Information


Identifiers and Pagination:

Year: 2021
Volume: 2
Issue: 2
First Page: 115
Last Page: 120
Publisher Id: nemj-2-115
DOI: 10.2174/0250688202666210520091911

Article History:

Received Date: 21/11/2020
Revision Received Date: 02/1/2021
Acceptance Date: 16/3/2021
Electronic publication date: 27/7/2021
Collection year: 2021

© 2021 Ben-Ishay et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at Department of General Surgery, Division of Surgery, Rambam Health Care Campus, 8 Ha'Aliyah st., Haifa 35254, Israel; Tel: 972-4-8541730; Fax: 972-4-8542321;
E-mail: o_ben-ishay@RMC.gov.il






Editor-in-Chief

Abdullah Shehab
Emirates Cardiac Society
Emirates Medical Association
Dubai
(UAE)
Biography
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Acceptance rate = 40%

Average review speed: 45 days average

18 days from acceptance to publication