AB103. 30. Discrepancies between clinical and pathological diagnoses of appendicular and gallbladder disease

Background: The purpose of this audit was to verify the pathological diagnosis following appendicectomy and cholecystectomy.

Methods: Between 2nd January and 31st December 2017, all consecutive histology specimens labelled ‘appendix’ and ‘gallbladder’ were reviewed retrospectively. The patient information management system was queried for further clinical information in all cases of normal histology.

Results: Seventy patients underwent appendicectomy. Sixty-one percent [43] were female. The mean (range) age was 40 [12–82] years. Sixty-one percent [43] had a final diagnosis of acute appendicitis; 2.8% [2] chronic appendicitis; 8.6% [6] perforated appendix; 3% appendiceal abscess; 1.4% [1] Crohn’s disease. Only 6 patients 7.1% (6) had normal appendicectomy specimens on histology. Three patients (4.3%) had acute inflammation with parasite infection. Three patients (4.3%) had fibrotic changes of the appendix and three patients (4.3%) had lymphoid hyperplasia of the appendix. One patient presented with low-grade appendicle mucinous neoplasm with perforation. One hundred and ninety-six patients underwent cholecystectomy. Sixty-three percent [124] were female. The mean age was 55 (range 20–84) years. Seventy-seven percent [152] had chronic cholecystitis. Fourteen percent [30] had acute cholecystitis. Two percent [4] had gallstones only. Three patients had a gangrenous acute cholecystitis. Two had gallbladder polyps and one patient had a diagnosis of adenocarcinoma.

Conclusions: Pathological evaluation of surgical specimens confirms high diagnostic accuracy for appendicectomy (93%) and cholecystectomy (100%) in our institution.

Keywords: Discrepancy; clinical; pathological