Presentation on theme: "Presented by : Sara Shokri Moghaddam. Anatomy & Function of appendix The three taeniae coli converge at the junction of the cecum with the appendix. The."— Presentation transcript:
Anatomy & Function of appendix The three taeniae coli converge at the junction of the cecum with the appendix. The tip of appendix can be found in a retrocecal,pelvic,subcecal,preileal or right pericolic position.
Anatomy & Function of appendix Appendix is an immunologic organ that participate in the secretion of IGs., specially IgA.
Incidence ≈ 7 % of all people andergoes appendectomy during their life More frequently in 2 nd through 4 th decades of life M > F The percentage of misdiagnosed cases of appendicitis is higher among women.
Etiology and Pathogenesis Obstruction of the lumen is the dominant etiologic factor of appendicitis. The most common cause of obstruction is fecaliths. Other causes:hypertrophy of limphoid tissue,inspissated barium,tumor,vegetable and fruit seeds and intestinal parasites.
Etiology and Pathogenesis A sequence of events lead to appendicitis: Proximal obstruction and normal secretion of mucosa Distention of appendix Stimulation of visceral afferent nerves a vague diffused pain in the midabdominal or lower epigastrium
Distention of appendix N/V occlusion of capillaries vascular congestion involvement of the serosa involvement of parietal peritoneum SHIFT in the PAIN to RLQ
Bacteriology The bacterial population of a normal appendix is similar to that of normal colon The principal organisms seen in the normal appendix,in acute appendicitis, and in perforated appendicitis are Escherichia coli & Bactroid fragilis.
AB prophylaxis Effective in prevention of wound infection and abcesses. 24-48h in non perforated appendicitis. 7-10D in perforated appendicitis.
Clinical manifestations SYMPTOMS: Abdominal pain Shifting of pain to the RLQ Anorexia N/V Sequence of symptoms: anorexia pain N/V(if accours)
Clinical manifestations SIGNS: Tendernes around Mcburney point Rebound tenderness Rovsing sign Guarding Obturator sign Psoas sign