Aseptic intussuscepted incidental appendectomy: three successful cases

Evangelia Rachmani, Zacharias Zachariou, Ulf Kessler

Berne, Switzerland

Author Affiliations: Department of Pediatric Surgery, Inselspital, University of Berne, Berne, Switzerland (Rachmani E, Kessler U); University of Berne, Berne, Switzerland (Zachariou Z)

Corresponding Author: Ulf Kessler, MD, Department of Pediatric Surgery, University of Berne, Inselspital, CH-3010 Berne, Switzerland (Tel: 0041 31 632 21 11; Fax: 0041 31 632 92 92; Email: ulf.kessler@insel.ch)

doi: 10.1007/s12519-013-0422-4

Background: Incidental appendectomy remains a controversial issue. We aimed to collect experience using a modified surgical technique that could be applied securely in infants.

Methods: We performed aseptic intussuscepted incidental appendectomy (AIIA) in three patients using a technique that is thought to assure appendix necrosis along with intact cecal wall.

Results: There was no perioperative morbidity due to AIIA in the three patients. In two infants the necrotic appendix was found in the diaper. One infant died secondary to diaphragmatic hernia. Autopsy with histological examination revealed that the cecum was intact along with appendix necrosis.

Conclusions: Modified AIIA could securely be performed in the 3 reported cases. We advocate prospective evaluation of the method.

Key words: appendectomy; appendicitis; inversion appendectomy

World J Pediatr 2013;9(4):369-372