Appendicitis is an inflammation of the vermiform appendix. The appendix is typically 10 cm long and located at the base of the caecum. It receives its blood supply from the appendicular artery. Symptoms of appendicitis include sudden pain in the lower right abdomen that shifts locations, nausea, vomiting, and fever. Diagnosis is based on symptoms and signs like rebound tenderness. Treatment involves intravenous antibiotics and analgesics initially, and an appendectomy if symptoms worsen or do not improve. Complications can include rupture, abscess formation, or infection spread.

1. A case study on Appendicitis
Presented by
Vd.Mayuri Mane

2. Introduction
Appendicitis is an inflammation of
the vermiform appendix.

3. Anatomy
 length = Avg 10 cms
 Position = the base of the appendix is
constant, being found at the confluence of the
three taeniae coli of the caecum, which fuse to
form the outer longitudinal muscle coat of the
appendix.
 Arterial supply = Appendicular artery branch
of Ileo colic artery
 Venous drainage = Appendicular veins drain
into ilio colic veins – Inferior mesentric veins
 Lymphatics vessels = Ileocaecal lymphnodes
 Functions = maturation of B lymphocytes
 Integral part of GALT (gut associated
lymphoid tissue)

4. ARTERIAL SUPPLY OF APPENDIX

5. Layer Of Appendix

6. Positions
Retrocaecal
Paracaecal
Subcaecal
Pelvi caecal
Pre ileal
Post ileal

7. Congenital
Abnormalities
Agenesis
Duplication
Diverticula
Left sided Appendix

8. Etiology
Obstruction
A) In the lumen = faecolith
B) In the wall = stricture , neoplasm
C) outside the wall = kinks,adhessions
Diet rich in cellulose and high residue
Social status = disease of aristocratic families
Familial susceptibility

9. pathology
1) OBSTRUCTIVE
A] Mucocele of appendix
B] Vascular congestion of appendix
C] Empyema of appendix
D] Infarcts
2) NON- OBSTRUCTIVE
Inflammation terminates by
Suppuration
Gangrene
Fibrosis
Resolution

10. Symptoms
Signs and symptoms of Appendicitis may
include:
Sudden pain that begins around your navel
and often shifts to your lower right abdomen
Pain in Rt lower quadrant
Nausea and vomiting
Loss of appetite
Fever that may worsen as the illness
progresses
Constipation or diarrhea

11. Signs
Murphys triad
Tachycardia , anxious look
Tongue is dry
Rebound tenderness
Rovsing sign
Obturator test
Psoas test

12. Murphystriad

14. OBTURATOR TEST +VE IN PELVIC
APPENDICITIS

15. PSOAS TEST +VE IN RECTOPELVIC
APPENDICITIS

16. Investigations

17. Differential Diagnosis

18. Complications
Ruptures
Mass (phlegmon)
Abscess
Suppurative pylephlebitis

19. Alvorado
score

20. Treatment
 Conservative management
1. IV Antibiotic
2. Antipyretic
3. Analgesic
4. Antacid
Surgical management
(Appendicectomy )

21. Whento
operate?
Criteria for stopping conservative
treatment of an appendix mass
• A rising pulse rate
• Increasing or spreading
abdominal pain
• Increasing size of the mass

22. Incisions
for
Appendecectomy

23. Layers

25. Post- operative
complications
Wound infection
Intrabadominal abscess
Fecal fistula
Intestinal obstruction