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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249


Enfermedades del apéndice cecal: Revisión de 10.424 casos en un período de 20 años. Arch. Pediatr. Urug. [online]. 2004, vol.75, n.1, pp.5-12. ISSN 1688-1249.

Objectives: 1)To review the pathologic findings in pediatric cecal appendix specimens studied in a 20 years period (1983-2003) at the Pereira Rossell Hospital (CHPR) and also at a private laboratory in the same period. 2) To compare the results in both places. Methods: all cecal appendices were studied by the authors and the same method was applied. The specimens were longitudinally sectioned after formalin fixation and the whole longitudinal cut surface was embedded for histological examination. Results: a total number of 10.424 cecal appendices were gathered; 6705 from CHPR and 3.719 from the private laboratory. 1.519 were normal specimens; 1.317 were early appendicitis; 502 were diffuse appendicitis without priappendiceal inflammation and finally 7.047 were appendicitis with transmural inflammation and periappendicitis. 11 cases were undetermined granulomatous appendicitis. 7 cases were fibrous obliteration of the lumen. Parasites (mainly enterobius vermicularis) where found in 7% of the cases studied in the late years. 21 cases of carcinoid tumors were found; most of them located at the middle third of the organ, with a median size of 7 mm; almost all the cases had concomitant appendicitis and most of the patients were adolescent females. The CHPR cases had less normals and early lesions than the private place, as well as more cases with periappendicitis. Conclusions: the longitudinal method of studying the cecal appendix allows a better recognition of many lessions that might otherwise be overlooked. Early lessions of appendicitis are better recognized and what is most important, carcinoid tumors located outside the tip can be diagnosed. The different incidence in the pathologic findings at both places may suggest that patients at the CHPR have a delayed request of medical attendance. The high percentage of parasitic infestation found in the late period mainly at the hospital series should be considered toghether with the socioeconomical status of the population served

Keywords : APPENDIX.

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