WHEN THE APPENDIX LIES: A CLINICOPATHOLOGICAL AUDIT OF NEGATIVE APPENDECTOMIES

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies. Despite advances in diagnostic modalities, negative appendectomy continues to pose a clinical challenge. Objectives: To evaluate the incidence of negative appendectomies and analyze clinicopathological correlates in patients undergoing appendectomy. Materials and Methods: This retrospective clinicopathological audit was conducted at TRR Institute of Medical Sciences, Sangareddy district, Telangana, over a one-year period (January 2024–January 2025). Clinical, radiological, intraoperative, and histopathological findings of appendectomy specimens were analyzed. Negative appendectomy was defined as absence of histological features of acute appendicitis. Results: A total of 56 appendectomy specimens were studied. Histopathology revealed acute appendicitis in 34 cases (60.7%), complicated appendicitis in 8 cases (14.3%), and negative appendectomy in 14 cases (25%). Negative appendectomy showed female predominance and was most common in the 20–35 year age group. Normal appendix and lymphoid hyperplasia were the most frequent findings. Conclusion: Negative appendectomy remains a significant concern. Histopathological examination plays a crucial role in definitive diagnosis and in identifying mimickers of acute appendicitis.