Appendix Pathology

Question 1

Describe acute appendicitis

Answer 1

Most common in adolescents and young adults that is thought to be initiated by progressive increases in intraluminal pressure that compromises venous outflow or by overt luminal obstruction by small stonelike mass of stool (aka fecalith), or less commonly a gallstone

Ischemic injury and stasis of luminal contents, which favor bacterial proliferation, trigger inflammatory responses including tissue edema and neutrophilic infiltration of the lumen, muscular wall, and periappendiceal soft tissues

Question 2

Diagnosis of acute appendicitis requires what?

Answer 2

neutrophilic infiltration of the muscularis propria

Question 3

How does acute appendicitis present?

Answer 3

it produces periumbilical pain that ultimately localizes to the RLQ, followed by N/V, fever, and a midly elevated WBC count.

McBurney’s Sign present

Question 4

What is the most common tumor of the appendix?

Answer 4

A carcinoid, frequently occuring on the distal tip of the appendix where it produces an asymptomatic swelling usually. Spread is rare