Research Article

Maximum Outer Diameter of Appendiceal Lesions: An Histopathological Approach

Abstract

The average maximal outer diameter (MOD) of the appendix in adults is 0.6 cm and in children, it is between 0.21-0.64 cm. Most of the assessment of MOD of the appendix has been from radiological diagnosis. We aim to determine the correlation between the MOD and lesions that occurred in the appendix from 2012 to 2022 in Bowen University Teaching Hospital, Anatomic pathology laboratory. The study was a retrospective one in which 315 participants with cases of appendiceal lesions were analysed in the lab. All reports containing complete biodata of patients, histopathological diagnosis including acute appendicitis, acute appendicitis with peritonitis, ruptured acute appendicitis and neoplasms from right hemi-colectomy specimen were included. Chronic granulomatous inflammation, haemorrhagic necrosis of the appendix in association with right hemicolectomy specimens were also included. All reports with incomplete biodata, histopathology lab number, samples whose dimensions were omitted, samples with irregularity in the lab number and date of submission of samples, or of reporting the results; unsigned reports and results not extracted from the archives were excluded. Also, appendixes with normal diagnosis, and follicular hyperplasia were excluded. Also excluded were reports whose sample blocks (formalin fixed paraffin embedded), and haematoxylin & eosin slides were not found. Convenience sampling was used and the lesions were categorized into 3 main groups based on their dimensions, group 1 (0.4-0.5cm), group 2 (1-1.5cm) and group 3 (2cm and above). Based on histopathology diagnosis, the samples were classified as acute appendicitis, acute appendicitis with peritonitis, and neoplasms and others. Appendiceal samples constitute about 56% of the GIT samples received. Only 3 neoplastic lesions were recorded. This constitute 0.01% of the lesions seen. The age group 20-29 had the highest number of participants (90) and the least participants were in the age range of 70 years and above. The median age of the group was 41.1 and the median age of the participants was 26.5 years. The category 1-1.5cm had the highest number of participants and this was not significant when compared to the other groups, p= 0.06824. There is also no significant association between age group and dimensions using loglinear test, AIC criterion and Poisson regression test. There is a slight occurrence of all the dimensions of the lesions in the male participants with a p value-0.0108. There is no significant difference between the appendiceal lesions in males and females. MOD of the appendix is an important feature of the appendix and the dimensions cuts across several age group and sex.