Assessment of negative appendectomy in acute appendicitis diagnoses
Background: A negative appendectomy is a surgery performed due to a clinical suspicion of acute appendicitis, but no evidence of inflammation is identified upon examination. The main reason is the incorrect diagnosis of acute appendicitis, which remains a challenge, especially in developing countrie...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | Surgery in Practice and Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666262025000105 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850127906678767616 |
|---|---|
| author | Francisco Antonio Rodriguez-Garcia Carlos Enrique Rodríguez-Sánchez Julio Cesar Naranjo-Chávez Christian Jorge Torres-Ortiz-Ocampo Fabián Rojas-Larios Karen Covarrubias-Ramírez Eduardo Missael Evangelista-Ruiz Quitzia Libertad Torres-Salazar |
| author_facet | Francisco Antonio Rodriguez-Garcia Carlos Enrique Rodríguez-Sánchez Julio Cesar Naranjo-Chávez Christian Jorge Torres-Ortiz-Ocampo Fabián Rojas-Larios Karen Covarrubias-Ramírez Eduardo Missael Evangelista-Ruiz Quitzia Libertad Torres-Salazar |
| author_sort | Francisco Antonio Rodriguez-Garcia |
| collection | DOAJ |
| description | Background: A negative appendectomy is a surgery performed due to a clinical suspicion of acute appendicitis, but no evidence of inflammation is identified upon examination. The main reason is the incorrect diagnosis of acute appendicitis, which remains a challenge, especially in developing countries, where the rates are different among populations. This study aims to explore the prevalence of negative appendectomies in a regional hospital and evaluate the diagnostic methods used in clinical practice. Materials and methods: A retrospective analysis was conducted on patients who underwent emergency appendectomy between 2021 and 2022. Negative appendectomy was defined as the absence of histopathological evidence of acute appendicitis postoperatively. Results: Out of 324 patients, 38 were found to have undergone a negative appendectomy, representing a two-year rate of 11.7%. Imaging was performed in 78% of cases, but no significant difference was observed in its use between patients with positive and negative appendectomies. Differential diagnoses showed pathologies such as cysts and intestinal lesions. The Alvarado score was found to be a useful tool when applied with a threshold score of 7. However, variability in clinical presentations such as nausea/vomiting, anorexia, right iliac fossa tenderness and fever highlighted the limitations of relying solely on this metric. The factors associated with negative appendectomy were previous abdominal surgery, Alvarado score <7, abdominal pain, rebound tenderness, leukocytosis and neutrophilia. Conclusions: The prevalence of negative appendectomies at our institution was 11.7%. Despite the widespread use of diagnostic imaging and clinical scoring systems, improvements in diagnostic accuracy are necessary to reduce the rate of unnecessary surgeries. |
| format | Article |
| id | doaj-art-b831dc1c6f564c43a4d4e67ac984ac52 |
| institution | OA Journals |
| issn | 2666-2620 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj-art-b831dc1c6f564c43a4d4e67ac984ac522025-08-20T02:33:32ZengElsevierSurgery in Practice and Science2666-26202025-06-012110028110.1016/j.sipas.2025.100281Assessment of negative appendectomy in acute appendicitis diagnosesFrancisco Antonio Rodriguez-Garcia0Carlos Enrique Rodríguez-Sánchez1Julio Cesar Naranjo-Chávez2Christian Jorge Torres-Ortiz-Ocampo3Fabián Rojas-Larios4Karen Covarrubias-Ramírez5Eduardo Missael Evangelista-Ruiz6Quitzia Libertad Torres-Salazar7Regional University Hospital of Colima, Colima, MexicoRegional University Hospital of Colima, Colima, MexicoRegional University Hospital of Colima, Colima, MexicoRegional University Hospital of Colima, Colima, MexicoRegional University Hospital of Colima, Colima, MexicoRegional University Hospital of Colima, Colima, MexicoRegional University Hospital of Colima, Colima, MexicoJuarez University of the State of Durango, Mexico; Correspondence author at. Director “Alpha 0.01” Biomedical Research Institute. Paloma 812, Colonia Fátima Durango, Dgo., C.P. 34060, México.Background: A negative appendectomy is a surgery performed due to a clinical suspicion of acute appendicitis, but no evidence of inflammation is identified upon examination. The main reason is the incorrect diagnosis of acute appendicitis, which remains a challenge, especially in developing countries, where the rates are different among populations. This study aims to explore the prevalence of negative appendectomies in a regional hospital and evaluate the diagnostic methods used in clinical practice. Materials and methods: A retrospective analysis was conducted on patients who underwent emergency appendectomy between 2021 and 2022. Negative appendectomy was defined as the absence of histopathological evidence of acute appendicitis postoperatively. Results: Out of 324 patients, 38 were found to have undergone a negative appendectomy, representing a two-year rate of 11.7%. Imaging was performed in 78% of cases, but no significant difference was observed in its use between patients with positive and negative appendectomies. Differential diagnoses showed pathologies such as cysts and intestinal lesions. The Alvarado score was found to be a useful tool when applied with a threshold score of 7. However, variability in clinical presentations such as nausea/vomiting, anorexia, right iliac fossa tenderness and fever highlighted the limitations of relying solely on this metric. The factors associated with negative appendectomy were previous abdominal surgery, Alvarado score <7, abdominal pain, rebound tenderness, leukocytosis and neutrophilia. Conclusions: The prevalence of negative appendectomies at our institution was 11.7%. Despite the widespread use of diagnostic imaging and clinical scoring systems, improvements in diagnostic accuracy are necessary to reduce the rate of unnecessary surgeries.http://www.sciencedirect.com/science/article/pii/S2666262025000105Negative appendectomyAcute appendicitisAlvarado scorePostoperatively diagnosis |
| spellingShingle | Francisco Antonio Rodriguez-Garcia Carlos Enrique Rodríguez-Sánchez Julio Cesar Naranjo-Chávez Christian Jorge Torres-Ortiz-Ocampo Fabián Rojas-Larios Karen Covarrubias-Ramírez Eduardo Missael Evangelista-Ruiz Quitzia Libertad Torres-Salazar Assessment of negative appendectomy in acute appendicitis diagnoses Surgery in Practice and Science Negative appendectomy Acute appendicitis Alvarado score Postoperatively diagnosis |
| title | Assessment of negative appendectomy in acute appendicitis diagnoses |
| title_full | Assessment of negative appendectomy in acute appendicitis diagnoses |
| title_fullStr | Assessment of negative appendectomy in acute appendicitis diagnoses |
| title_full_unstemmed | Assessment of negative appendectomy in acute appendicitis diagnoses |
| title_short | Assessment of negative appendectomy in acute appendicitis diagnoses |
| title_sort | assessment of negative appendectomy in acute appendicitis diagnoses |
| topic | Negative appendectomy Acute appendicitis Alvarado score Postoperatively diagnosis |
| url | http://www.sciencedirect.com/science/article/pii/S2666262025000105 |
| work_keys_str_mv | AT franciscoantoniorodriguezgarcia assessmentofnegativeappendectomyinacuteappendicitisdiagnoses AT carlosenriquerodriguezsanchez assessmentofnegativeappendectomyinacuteappendicitisdiagnoses AT juliocesarnaranjochavez assessmentofnegativeappendectomyinacuteappendicitisdiagnoses AT christianjorgetorresortizocampo assessmentofnegativeappendectomyinacuteappendicitisdiagnoses AT fabianrojaslarios assessmentofnegativeappendectomyinacuteappendicitisdiagnoses AT karencovarrubiasramirez assessmentofnegativeappendectomyinacuteappendicitisdiagnoses AT eduardomissaelevangelistaruiz assessmentofnegativeappendectomyinacuteappendicitisdiagnoses AT quitzialibertadtorressalazar assessmentofnegativeappendectomyinacuteappendicitisdiagnoses |