Incidental appendectomy after esophageal bypass for treatment of dysphagia

Background: The lifetime risk of acute appendicitis is 7-14%. Incidental appendectomy is defined as the removal of a clinically normal appendix during non-appendiceal surgery. Guidelines have tried to determine candidates for incidental appendectomy, but the practice continues to attract controversies. This paper presents our observation after appendectomy performed during oesophageal bypass/replacement procedures for treatment of dysphagia. Patients and Method: The histology results of all who underwent oesophageal bypass/replacement patients for the treatment of dysphagia was trace from the patient's hospital records and histopathology register. Results: A total of 28 patients underwent oesophageal bypass /replacement procedure between 2008 – 2015, during which 25 had incidental appendectomy. We were able to retrieve the histology of only 7 patients (3 males and 4 females). Of these, one male had a normal appendix another had lymphoid hyperplasia. Four patients had acute recurrent appendicitis (3 females with corrosive stricture and one male with HIV associated inflammatory stricture). Conclusions: There is a high incidence of incidental appendicitis in patients with dysphagia justifying the need for incidental appendectomy as prophylaxis against future exploration which may put the conduit in harm's way.