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Appendiceal Obliterans Fibrosis: A Five-Year Case Series Report in a Community Hospital

Received: 26 September 2024     Accepted: 14 October 2024     Published: 18 November 2024
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Abstract

Acute appendicitis is the most common appendiceal disease, however, there are some chronic inflammatory disease pathologies such as appendiceal obliterans (AO) that mimic acute appendicitis. We present a five-year retrospective case series analysis in a community hospital for patients who underwent appendectomy. Fibrous obliteration of the appendix occurs when there is a replacement of the mucosa and submucosa with fibrotic tissues. In a small community hospital, there were 195 patients that underwent appendectomy within a five-year period, in which 6.66% of patients' final pathology confirmed AO. There are some similar clinical symptoms and computed tomography (CT) findings of AO that can mimic acute appendicitis, but there is no consensus for any criteria to definitively diagnose this condition radiologically. The current method to determine the etiology of this appendiceal condition is through appendectomy followed by histological evaluation by a pathologist. We aim to analyze prior patients and their risk factors to find an alternative diagnostic method. We explore several factors including age, to determine if there can be any basis to creating a diagnostic criterion for this condition. The mean age within our case series was 58 years old. While fibrous obliteration of the appendix is a chronic inflammatory process, patients may present with acute abdominal pain, making the diagnosis difficult. Therefore, clinicians should make AO a part of their differential diagnosis which may require surgical intervention.

Published in World Journal of Medical Case Reports (Volume 5, Issue 2)
DOI 10.11648/j.wjmcr.20240502.11
Page(s) 18-22
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Fibrous Obliteration, Appendiceal Obliterans, Appendectomy, Acute Appendicitis, Neuroendocrine, Pathology, General Surgery

References
[1] Olsen, B. S., & Holck, S. (1987). Neurogenous hyperplasia leading to appendiceal obliteration: an immunohistochemical study of 237 cases. Histopathology, 11(8), 843–849.
[2] Leibovitch, I., Avigad, I., Nativ, O., & Goldwasser, B. (1992). The frequency of histopathological abnormalities in incidental appendectomy in urological patients: the implications for incorporation of the appendix in urinary tract reconstruction. The Journal of urology, 148(1), 41–43.
[3] Petroianu, A., Barroso, T. V. V., Buzelin, M. A., Theobaldo, B. M., & Tafuri, L. S. A. (2020). Neuroendocrine apendicopathy in morphologically normal appendices of patients with diagnosis of acute appendicitis: Diagnostic study. Annals of medicine and surgery (2012), 60, 344–351.
[4] Li Y, Li M, Li X, Sang H. Metastasis to the appendix from adenocarcinoma of the ascending colon: A case report. Medicine (Baltimore). 2017 Mar; 96(11): e6357.
[5] Dincel O, Göksu M, Türk BA, Pehlivanoğlu B, İşler S. Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients. Indian J Surg. 2018 Feb 80(1): 48-53.
[6] Sarathy KR, Samee A (2021) Pristine Normal Looking Appendix on Diagnostic Laparoscopy-A Management Dilemma. Int J Surg Res Pract 8: 135.
[7] Choi, Sun-Ju & Jang, Yun-Jin & Lee, Dakeun & Cho, S. & Kim, Gab & Bae, Ji & Park, Jin & Cheon, Jae. (2014). Two Cases of Fibrous Obliteration of the Appendix, Mimicking Acute Appendicitis. Journal of the Korean Society of Radiology. 70. 430.
[8] Joseph Misdraji, Fiona M. Graeme-Cook, Miscellaneous conditions of the appendix, Seminars in Diagnostic Pathology, Volume 21, Issue 2, 2004, Pages 151-163, ISSN 0740-2570,
[9] Gonzales, R. S. (2021, April 28). Appendix - fibrous obliteration.
[10] Weissleder, R., & Al, E. (2011). Primer of diagnostic imaging (5th ed., pp.147-148). Elsevier Mosby.
[11] Davis CR, Trevatt A, Dixit A, Datta V. Systematic review of clinical outcomes after prophylactic surgery. Ann R Coll Surg Engl. 2016 Jul; 98(6): 353-7.
[12] Echevarria S, Rauf F, Hussain N, Zaka H, Farwa UE, Ahsan N, Broomfield A, Akbar A, Khawaja UA. Typical and Atypical Presentations of Appendicitis and Their Implications for Diagnosis and Treatment: A Literature Review. Cureus. 2023 Apr 2; 15(4): e37024.
Cite This Article
  • APA Style

    Uddin, T., Aktar, M., Islam, R., Quazi, N., Wilson, A. (2024). Appendiceal Obliterans Fibrosis: A Five-Year Case Series Report in a Community Hospital. World Journal of Medical Case Reports, 5(2), 18-22. https://doi.org/10.11648/j.wjmcr.20240502.11

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    ACS Style

    Uddin, T.; Aktar, M.; Islam, R.; Quazi, N.; Wilson, A. Appendiceal Obliterans Fibrosis: A Five-Year Case Series Report in a Community Hospital. World J. Med. Case Rep. 2024, 5(2), 18-22. doi: 10.11648/j.wjmcr.20240502.11

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    AMA Style

    Uddin T, Aktar M, Islam R, Quazi N, Wilson A. Appendiceal Obliterans Fibrosis: A Five-Year Case Series Report in a Community Hospital. World J Med Case Rep. 2024;5(2):18-22. doi: 10.11648/j.wjmcr.20240502.11

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  • @article{10.11648/j.wjmcr.20240502.11,
      author = {Tanjil Uddin and Mohammad Aktar and Rayan Islam and Nadim Quazi and Abralena Wilson},
      title = {Appendiceal Obliterans Fibrosis: A Five-Year Case Series Report in a Community Hospital
    },
      journal = {World Journal of Medical Case Reports},
      volume = {5},
      number = {2},
      pages = {18-22},
      doi = {10.11648/j.wjmcr.20240502.11},
      url = {https://doi.org/10.11648/j.wjmcr.20240502.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20240502.11},
      abstract = {Acute appendicitis is the most common appendiceal disease, however, there are some chronic inflammatory disease pathologies such as appendiceal obliterans (AO) that mimic acute appendicitis. We present a five-year retrospective case series analysis in a community hospital for patients who underwent appendectomy. Fibrous obliteration of the appendix occurs when there is a replacement of the mucosa and submucosa with fibrotic tissues. In a small community hospital, there were 195 patients that underwent appendectomy within a five-year period, in which 6.66% of patients' final pathology confirmed AO. There are some similar clinical symptoms and computed tomography (CT) findings of AO that can mimic acute appendicitis, but there is no consensus for any criteria to definitively diagnose this condition radiologically. The current method to determine the etiology of this appendiceal condition is through appendectomy followed by histological evaluation by a pathologist. We aim to analyze prior patients and their risk factors to find an alternative diagnostic method. We explore several factors including age, to determine if there can be any basis to creating a diagnostic criterion for this condition. The mean age within our case series was 58 years old. While fibrous obliteration of the appendix is a chronic inflammatory process, patients may present with acute abdominal pain, making the diagnosis difficult. Therefore, clinicians should make AO a part of their differential diagnosis which may require surgical intervention.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Appendiceal Obliterans Fibrosis: A Five-Year Case Series Report in a Community Hospital
    
    AU  - Tanjil Uddin
    AU  - Mohammad Aktar
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    AU  - Nadim Quazi
    AU  - Abralena Wilson
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    DO  - 10.11648/j.wjmcr.20240502.11
    T2  - World Journal of Medical Case Reports
    JF  - World Journal of Medical Case Reports
    JO  - World Journal of Medical Case Reports
    SP  - 18
    EP  - 22
    PB  - Science Publishing Group
    SN  - 2994-726X
    UR  - https://doi.org/10.11648/j.wjmcr.20240502.11
    AB  - Acute appendicitis is the most common appendiceal disease, however, there are some chronic inflammatory disease pathologies such as appendiceal obliterans (AO) that mimic acute appendicitis. We present a five-year retrospective case series analysis in a community hospital for patients who underwent appendectomy. Fibrous obliteration of the appendix occurs when there is a replacement of the mucosa and submucosa with fibrotic tissues. In a small community hospital, there were 195 patients that underwent appendectomy within a five-year period, in which 6.66% of patients' final pathology confirmed AO. There are some similar clinical symptoms and computed tomography (CT) findings of AO that can mimic acute appendicitis, but there is no consensus for any criteria to definitively diagnose this condition radiologically. The current method to determine the etiology of this appendiceal condition is through appendectomy followed by histological evaluation by a pathologist. We aim to analyze prior patients and their risk factors to find an alternative diagnostic method. We explore several factors including age, to determine if there can be any basis to creating a diagnostic criterion for this condition. The mean age within our case series was 58 years old. While fibrous obliteration of the appendix is a chronic inflammatory process, patients may present with acute abdominal pain, making the diagnosis difficult. Therefore, clinicians should make AO a part of their differential diagnosis which may require surgical intervention.
    
    VL  - 5
    IS  - 2
    ER  - 

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