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ACUTE APPENDICITIS
Definition: Acute appendicitis is inflammation of the appendix.
Anatomy
Layers of the wall of the appendix
Serous coat
Muscular coat; outer longitudinal, inner circular
Submucosa: has lymphoid tissue and lymphoid follicles
Mucous coat; similar to hat of the large intestines
Appendix has mesentery called mesoappendix.
McBurneys point corresponds to the base of the appendix. McBurneys point
is located on the line drawn from the anterior superior iliac spine to the
umbilicus. The one-third of this line that is closest to the anterior iliac spine is
McBurneys point.
Blood supply:
Appendix is supplied by the appendicular artery, which is a branch of the
ileocolic artery. The appendicular artery reaches the tip of the appendix. The
accessory appendicular artery, a branch of the posterior cecal artery supplies
of the base of appendix.
The appendix is drained by the appendicular vein which travels with the
appendicular artery.
Anatomical positions of the appendix
Retorcecal
Pelvic
Subcecal
Periileal
Right pericolic
Role of the appendix
The appendix is also known as the abdominal tonsil. It is invovled in
maturation of B lymphocytes (its lymphoid follicles) and is part of the GALT
9gut associated lymphoid system)
Etiology of acute appendicitis:
1. Obstruction of the lumen of the appendix by a fecolith or hyperplasia
of submucosa lymphoid follicles. It is the most common cause of acute
appendicitis. Other causes of obstruction: worms, fruit seeds, etc