Few Important Aspects About Appendicitis

Appendicitis is a severe painful medical condition (can be acute or chronic) which is characterized by inflammation of appendix (an obsolete human organ extending from large intestine with no demonstrate-able function and in grass eating animals it helps in digestion of grass). Appendicitis is a medical emergency condition and in many cases, requires removal of inflamed appendix. The removal of appendix is mainly done by laparoscopic surgery. Appendicitis is one of the most common causes of severe acute abdominal pain across the globe. The mortality is high among untreated cases, due to complications such as peritonitis (inflammation of peritoneum) and shock.

What are the causes of appendicitis?

The most important cause of appendicitis appears to be the obstruction of the lumen of the appendix, according to most experts in the field. If there is obstruction of the lumen of appendicitis, as the lumen becomes filled with mucus it swells and there is increase in pressure within the lumen as well as at the walls of the lumen. Due to increase in the pressure, the small blood vessels and the lymphatic vessels get occluded and lymphatic flow stops.

Due to occlusion of small blood vessels the appendix may become ischemic and necrosis occurs. In the necrotic area of the lumen of appendix, bacteria grow and may leak through the necrotic wall and pus formation occurs. If patient is left untreated the appendix may rupture (known as burst appendix) and results in peritonitis, septicemia and eventually death.

The causative agents of appendicitis include foreign bodies inside appendix lumen (which may occlude the lumen), trauma, worms, calcified deposits inside appendix known as appendicoliths, lymphadenitis, fecalith (presence of feces or stool inside the lumen) etc. Presence of feces inside appendix lumen has recently attracted attention and is considered one of the several important causative factors. Presence of fecalith is associated with complicated appendicitis. The prevalence of fecalith in patients with appendicitis is much higher in developed than in developing countries and can be due to low fiber intake in developed countries.

What is pseudo-appendicitis?

The term pseudo-appendicitis is used for conditions which mimic appendicitis, but not due to inflammation of appendix. Yersinia enterocolitica is one of the causative agents of pseudo-appendicitis.


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