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Surgery.(GIT 3).Appendix > 1. ACUTE APPENDICITIS (Incidence, Etiology and pathology) > Flashcards

1. ACUTE APPENDICITIS (Incidence, Etiology and pathology) Flashcards

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1
Q

INCIDENCE of ACUTE APPENDICITIS

A

Commonest cause of acute abdomen.

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2
Q

Variation in the position of the tip of the appendix

A
  1. Retrocaecal 74%
  2. pelvic 21%
  3. Paracaecal
  4. Subcaecal
  5. Preilial
  6. postilial
  7. Subserous
  8. Subhepatic
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3
Q

Pathogenesis of Subserous appendix in Variation in the position of the tip of the appendix

A

when it lies beneath the serosa of the caecum

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4
Q

Pathogenesis of Subhepatic appendix inVariation in the position of the tip of the appendix

A

failure of descent of the caecum

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5
Q

Etiology of ACUTE APPENDICITIS

A

(A) Non-obstructive (1/3)

B) Obstructive (2/3

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6
Q

Pathogenesis of Non-obstructive Etiology of ACUTE APPENDICITIS

A

Constipation.

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7
Q

Pathogenesis of Obstructive Etiology of ACUTE APPENDICITIS

A

Obstruction may be in :
* Lumen :

  • Wall:
  • Outside the wall: .
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8
Q

Lumen Obstruction in Pathogenesis of Obstructive Etiology of ACUTE APPENDICITIS

A
  • F.B ( fruit seeds)
  • parasites ( oxyuris or ascaris worms)
  • faecal concretions.
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9
Q

Wall Obstruction in Pathogenesis of Obstructive Etiology of ACUTE APPENDICITIS

A
  • Stricture
  • Tumour.
  • Crohn’s
  • Lymphoid tissue hyperplasia
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10
Q

Outside the wall Obstruction in Pathogenesis of Obstructive Etiology of ACUTE APPENDICITIS

A
  • Adhesions
  • kinks
  • mass
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11
Q

PATHOLOGY of ACUTE APPENDICITIS

A
  • Organisms
  • Route of spread
  • Pathological stages
  • Fate
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12
Q

Organisms in PATHOLOGY of ACUTE APPENDICITIS

A
  • E. coli
  • streptococcal faecalis
  • streptococcal viridans
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13
Q

Route of spread in PATHOLOGY of ACUTE APPENDICITIS

A

Direct from the lumen ( Rarely blood ).

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14
Q

Pathological stages in PATHOLOGY of ACUTE APPENDICITIS

A

(1) Acute catarrhal :
(2) Acute suppurative.
(3) Acute gangrenous

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15
Q

Pathogenesis of Acute catarrhal in Pathological stages in PATHOLOGY of ACUTE APPENDICITIS

A

Inflammation is confined to the mucosa.

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16
Q

Pathogenesis of Acute gangrenous in Pathological stages in PATHOLOGY of ACUTE APPENDICITIS

A
  • Leading to perforation
  • ln non obstructive type
  • ln obstructive type
  • Perforation is more common with obstructive appendicitis
17
Q

perforation ln non obstructive type in Pathogenesis of Acute gangrenous in Pathological stages in PATHOLOGY of ACUTE APPENDICITIS

A

Perforation occurs at the tip

18
Q

the reason why perforation ln non obstructive type occurs at the tip , in Pathogenesis of Acute gangrenous in Pathological stages in PATHOLOGY of ACUTE APPENDICITIS

A

due to thrombosis of the appendicular artery.

19
Q

perforation ln obstructive type in Pathogenesis of Acute gangrenous in Pathological stages in PATHOLOGY of ACUTE APPENDICITIS

A

Perforation occurs at the site of obstruction.

20
Q

Fate in PATHOLOGY of ACUTE APPENDICITIS

A

A. Non-obstructive Type :

B. Obstructive Type :

21
Q

Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A
  • Inflammatory process
  • The appendicular mass:
  • Sequel
22
Q

Inflammatory process in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A
  1. The course of the inflammatory process is slow
  2. The omentum surrounds the inflamed appendix
  3. an “Appendicular Mass” forms on the 3rd day after the beginning of the attack of acute appendicitis
23
Q

The appendicular mass in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A
  • Alternative name

* Components

24
Q

Alternative name for The appendicular mass in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

peri-appendicular phlegmon

25
Q

Components of The appendicular mass in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

a) Appendix in center.
b) Surrounded by loop of gut.

c) And all are wrapped by omentum ( policeman of the abdomen) forming closed box preventing this
inflamed focus from affecting other structures.

26
Q

Sequel in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

a) Complete resolution under medical treatment.

b) Perforation (at the tip) may however occur inside the mass causing “ Appendicular Abscess”.

27
Q

The Appendicular Abscess in Sequel in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

a) Its location

B) Fate:

28
Q

Location of The Appendicular Abscess in Sequel in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

is governed by the location of the appendix thus it may be retrocaecal, pelvic, subcaecal, preilial and postilial

29
Q

Fate of The Appendicular Abscess in Sequel in Non-obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

A big abscess may point in the abdominal wall or may burst in the rectum or vagina or in the peritoneal cavity )> peritonitis

30
Q

Obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

The inflammatory process

Sequel

31
Q

The inflammatory process in Obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

The course of the inflammatory process is rapid causing perforation (at the site of obstruction) before the defensive mechanism has occurred.

32
Q

Sequel in Obstructive Type Fate in PATHOLOGY of ACUTE APPENDICITIS

A

Perforation causes generalized peritonitis (Within the 1st 48 hours).

Surgery.(GIT 3).Appendix (3 decks)

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