Appendix-its Overview

 

Vermiform appendix is a vestigial organ which is tubular structure. It has irregular lumen and it is a lymphoid organ.

Length:7.5-10cm

Lining epithelium:columnar epithelium.

Different  Anatomical positions of appendix:

·        Retroceacal 74%

·        Pelvic 21%

·        Subcaecal 1.5%

·        Paracaecal 2%

·        Preileal 1%

Structure:

·        Mucosa:simple columnar epithelium.

·        Submucosa:aggregated lymphatic follicle.

·        Muscular layer

·        Serosa

·        Mc burneys point:At the junction of the lateral 1/3^rd and medial 2/3^rd of a line joining the Right anterior superior Iliad spine and umbilicus.

 

Parts:Base,body,tip

 

Artery supply:Appendicular artery branch of lower division of ileo-colic artery.

Diseases:Appendicitis :Inflammation  of the vermiform appendix.

1.       Classification:

1.       Acute appendicitis:

1.Acute obsobstructiv

2.Acute non obstructive

2.       Recurrent  appendicitis

Pathological classification:

3.       Catarrhal

4.       Supportive

5.       Gangrene

Typical presentation of Acute appendicitis:

Symptoms:1.pain in the abdomen ,which is colicky in nature.initially around the umbilicus which later shifted to the Right Iliad fossa.

2.Anorexia,nausea

3.Vomi3.Vomi.Diarrhoea,frequency,dysuria in Pelvic variety.

Sign:

1.       Mc burneys point tenderness:maximum  tenderness in Mc burneys point.

2.       Muscle guarding and rigidity over the point of maximum  tenderness.

3.       Rebound tenderness

4.       Rovsign's sign positive.

5.       Poas sign:positive in Retroceacal appendix. 

6.       Obturator sign:positive in Pelvic appendix.

 

Treatment:

·        Appendisectomy as early as possibl

·        Peri operative antibiotics

·        If peritonitis is suspected,antibiotics  in I/V route.

·        If children with Pyrexia,antibiotics, IV fluid and salicylates.