APPENDIX. James Taclin C. Banez, MD, FPSGS,FPCS. Anatomy / Function. Location, position Function: Immunologic organ Secrets IgA, component of the GUT associated lymphoid tissue (GALT) Not essential; it’s removal ----> (-) sepsis. Appendiceal Conditions of Surgical Importance.
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James Taclin C. Banez, MD, FPSGS,FPCS
Proximal occlusion ---> Closed loop Obst. ---- ---> rapid distention due to:
---> elevate pressure ---> capillary/venous occlusion (CONGESTION 1st stage):
S/Sx: (+) visceral afferent pain fibers (vague, dull, diffuse pain in mid-abdomen or lower epigastrium. Increase peristalsis (crampy pain); N/V and anorexia
Signs: PE depends on the location of the appendix and presence of rupture
Stages I & II – uncomplicated
Stages III & IV – complicated
simple = 10,000 to 18,000/mm3
perforated = >18,000/mm3
highly suggestive of the dx.
78–96% sensitivity; 85–98% specificity
(+) non-compressible appendix, 6mm or > at AP view
(-) easily compressible 5mm; not visualized a & (-) pericecal fluid or mass
Appendicitis confined at the tip
Periappendicitis from surrounding inflammation
Dilated fallopian tube
Inspissated stool can mimic an appendicitis
Obese pt., appendix not compressedAppendicitis
Useful for female to diferrentiate gynecological pathologyAppendicitis
right paramedian; midline incision
> 2cm right hemicolectomy