The document discusses the anatomy, development, function, and clinical presentation of appendicitis of the appendix. It describes the appendix as a thin tube located in the lower right abdomen that develops from the cecum and contains lymphoid tissue. While its function was originally unknown, it is now believed to play a role in immune function as lymphoid tissue accumulates after birth, exposing white blood cells to antigens from the gastrointestinal tract. Acute appendicitis occurs when the appendix becomes blocked and infected, most commonly from lymphoid hyperplasia or fecaliths. Clinical features include abdominal pain that localizes to the right lower quadrant along with nausea, vomiting, and fever. Diagnosis involves examination
This is an oblique intermuscular passage in the lower part of the anterior abdominal wall ,
Situated just above the medial half of the inguinal ligament
This is an oblique intermuscular passage in the lower part of the anterior abdominal wall ,
Situated just above the medial half of the inguinal ligament
Describe the structures, relations, and functions of the adrenal gland.
describe the histological structures and clinical importance of the adrenal gland
Describe the structures, relations, and functions of the adrenal gland.
describe the histological structures and clinical importance of the adrenal gland
A brief anatomical, embryological, patho-physiological and surgical description of the Vermiform Appendix.
Surface Anatomy of Appendix, Appendicectomy, surgical approach, complications, Appendicular lump and abscess, Neoplasia, Carcinoid syndrome, Pseudomyxoma Peritonei, The Alvarado Score
Hydatid cysts are most commonly found in the liver and lungs, although they may also occur in other organs, bones and muscles. The cysts can increase in size to 5 – 10 cm or more and may survive for decades. Non-specific signs include loss of appetite, weight loss and weakness
Echinococcus granulosus sensu lato occurs practically worldwide, and more frequently in rural, grazing areas where dogs ingest organs from
diagnosis
epidemiology
managment
Primary Gastric Actinomycosis: The first ever report of Primary Gastric Actinomycosis from India.
Source: International Journal of Medical Research & Health Sciences
Spindle cell neoplasms usually occur in head, neck, orbit, soft tissues of scalp and along the upper aerodigestive tract. They are relatively uncommon in lower gastrointestinal tract and represent a distinct clinical entity. Increased awareness is required among colorectal surgeons and pathologists due to their benign nature & uncertain etiology, to avoid misdiagnosis of rectal cancer. Definitive diagnosis necessitates immunohistochemical analysis. We present an unusual case of spindle cell neoplasm of rectum in an asymptomatic elderly gentleman, detected on screening colonoscopy. Following thorough evaluation with MRI pelvis, CT scan thorax, abdomen, pelvis with contrast and multidisciplinary meeting discussion (MDT) at our institution, he was successfully treated with a specialized minimally invasive approach (TAMIS). Histopathology with immunohistochemistry confirmed the diagnosis of spindle cell neoplasm. As they are uncommon in colorectum & non-invasive, management and long-term follow-up is still under study. These lesions should be differentiated from other stromal tumours in GIT.
PowerPoint presentation on Choledochal Cysts, also known as biliary cyst, uploaded by Dr. Vaskar Humagain, first presented in 31st December, 2013. This presentation contains all the information about Choledochal Cysts, the original and revised Todani classification of choledochal cysts, pathogenesis, other associated congenital anomalies, clinical features in infant and adult, management of choledochal cysts. Comments are highly welcome :)
A Case of Postmenopausal Pyometra Caused By Endometrial Tuberculosisiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Anatomy and physiology of spleen and laparoscopic management of splenic diso...Dr Sajad Nazir
This ppt. Is about the surgical anatomy, physiology,functions of spleen and laparoscopic management of splenic disorder.
Most of the anatomy is depicted pictorial and with suitable diagrams and is recommended for postgraduates only.
Most of Laparoscopic splenectomy has been made understand by diagrams only after consulting different standard surgical books.
Inflammatory fibroid polyp (Vanek’s tumour) of the bowel KETAN VAGHOLKAR
Inflammatory fibroid polyp (IFP) or Vanek’s tumour is a rare benign tumour of the gastrointestinal tract. Lower gastrointestinal IFP’s may present as an acute abdomen in the form of an intussusception in an adult. The surgeon needs to be aware of this entity to avert misdiagnosis. An abdominal CT or an MRI is helpful in diagnosing an acute abdomen due to IFP in an adult. Surgery is the mainstay of treatment. The etiopathology and management of this rare tumour is discussed.
Hirschsprung Disease - Approach & ManagementVikas V
Hirschsprung Disease. - A developmental Disorder of Intrinsic Component of Enteric Nervous System.
Also known Congenital Megacolon.
This Presentation deals with The eitology, presentation, diagnosis, medical and surgical management & complications of the same.
Origin of life in universe is most debating and interesting topic for all scientist .which divided in 3 parts chemosynthesis theory ,RNA world hypothesis and some evidence about extraterrestrial life.
India is not that country of religions its country of unity ,love and purity where peoples live with big heart . but still India is different than world . just watch it and it will be use full for Indians to know where we are
Epidermodysplasia verruciformis which is from papiloma virus and cause Very Dangerous diseases which called as Tree Man Illness in this description some molecular markers are use to detection of this virus
Topic from Molecular ecology in which its possible to sexual selection According to color Polymorphism In small animals Like fish,butterfly,birds In laboratory scale by applying Molecular makrers
there are s many methods are used in diagnosis of human gene mutation which occur disorders ,here u get information about the diagnostic method for genetic mutation detection
Understanding of Models use for biomedical research who have similar physiological function like humans ,and the how to generate and which models are useful
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. The Appendix
Introduction
1889 Mac Burney described location, the clinical
features of appendicitis and the importance of
operative intervention and muscle-splitting
incision.
Molecular Immunogenetics
3. The Appendix
Surgical Anatomy
Surface anatomy
Development: diverticulum of ceacum appearing in
the 8th
week of life
Positions: constant base, tip varies (retroceacal, pelvic,
subcaecal, preileal, pericolic)
Blood supply
Location during surgery
Surrounding anatomical structures
Part of the gut lymphoid tissue.
Molecular Immunogenetics
6. Molecular Immunogenetics
The appendix sits at the junction of the small intestine and
large intestine. It’s a thin tube about four inches long. Normally,
the appendix sits in the lower right abdomen.
The function of the appendix is unknown. One theory is that
the appendix acts as a storehouse for good bacteria,
“rebooting” the digestive system after diarrheal illnesses. Other
experts believe the appendix is just a useless remnant from
our evolutionary past. Surgical removal of the appendix causes
no observable health problems.
7. Molecular Immunogenetics
For years, the appendix was credited with very little physiological
function. We now know, however, that the appendix serves an
important role in the fetus and in young adults. Endocrine cells appear
in the appendix of the human fetus at around the 11th week of
development. These endocrine cells of the fetal appendix have been
shown to produce various biogenic amines and peptide hormones,
compounds that assist with various biological control (homeostatic)
mechanisms. There had been little prior evidence of this or any other
role of the appendix in animal research, because the appendix does not
exist in domestic mammals.
8. Molecular Immunogenetics
Among adult humans, the appendix is now thought to be involved
primarily in immune functions. Lymphoid tissue begins to accumulate
in the appendix shortly after birth and reaches a peak between the
second and third decades of life, decreasing rapidly thereafter and
practically disappearing after the age of 60. During the early years of
development, however, the appendix has been shown to function as a
lymphoid organ, assisting with the maturation of B lymphocytes (one
variety of white blood cell) and in the production of the class of
antibodies known as immunoglobulin A (IgA) antibodies. Researchers
have also shown that the appendix is involved in the production of
molecules that help to direct the movement of lymphocytes to various
other locations in the body
9. Molecular Immunogenetics
In this context, the function of the appendix appears to be to expose
white blood cells to the wide variety of antigens, or foreign
substances, present in the gastrointestinal tract. Thus, the appendix
probably helps to suppress potentially destructive humoral (blood-
and lymph-borne) antibody responses while promoting local
immunity. The appendix--like the tiny structures called Peyer's
patches in other areas of the gastrointestinal tract--takes up antigens
from the contents of the intestines and reacts to these contents. This
local immune system plays a vital role in the physiological immune
response and in the control of food, drug, microbial or viral antigens.
The connection between these local immune reactions and
inflammatory bowel diseases, as well as autoimmune reactions in
which the individual's own tissues are attacked by the immune
system, is currently under investigation.
10. The Appendix
Acute Appendicitis
Epidemiology
Most common surgical emergency.
Slightly more common in men.
Incidence are falling from 100 to 50 in 100 000 (1975-1991).
1 in 6 of the population will have an appendectomy.
In Saudi Arabia incidence are comparable to western figures
? More common in European societies (Diet).
? Relation to class status.
Age > 2 yrs, (associated with lymphoid development).
Up to 16% of appendicectomies are normal 75% are in women
Molecular Immunogenetics
11. The Appendix
Acute Appendicitis
Pathology I
Luminal obstruction.
Lymphoid hyperplasia 60%
Faecolith 35%.
Inspissated barium.
Fruit seeds. }<4%
Worms. < 1%
Extra-luminal obstruction eg Ca Cecum
Raised intra-luminal pressure
Mucus accumulation
Multiplication of bacteria.
( E.Coli, Bacteroids, peptostreptococcus, Psuedomonas)
Venous and lymphoid congestion and.
Molecular Immunogenetics
12. The Appendix
Acute Appendicitis
Pathology II
Impaired arterial flow, thrombosis and gangrene.
Perforation may occur through devitalized tissue.
Histological terms used:
Catarrhal appendicitis
Suppurative ;;;
Necrotic ;;;
Gangrenous ;;;
Perforated ;;;
Appendicular mass
The risk of perforation is not inevitable.
Molecular Immunogenetics
13. The Appendix - Acute Appendicitis
Clinical Features I
Only 55% have classical features.
Atypical 45%
History 24-36 hours
Abdominal pain:
(diffuse and periumbilical, localizing to the RIF)
Anorexia (almost always).
Vomiting (75%).
Low grade fever.
If >38 suspect perforation
Tenderness, guarding and rebound: Be gentle
Rovsing’s, psoas, obturator signs: unreliable and late
Molecular Immunogenetics
Full History Duration, severity, onset, System review.
and examination: General, throat, chest…..etc
14. The Appendix - Acute Appendicitis
Clinical Features II
Tender Appendicular mass
Atypical:
(loin, high RUQ, deep pelvic)
Diarrhea ( not always gastroenteritis)
Urinary frequency
The Extremes of Age:
Children < 5 rapid progression
Pain in the elderly is less intense
Molecular Immunogenetics
15. The Appendix - Acute Appendicitis
Investigations
White cell count: high sensitivity 96%, low specificity
Urine analysis
Plain Xray, nonspecific
Ultrasound highly sensitive (80-90%), excludes
other pathologies.
Computer Tomography: More superior to USS in diagnostic accuracy.
Barium enema: Good accuracy, but technically
difficult and false positives are common.
Laparoscopy
Active observation
Computer aided diagnosis.
Peritoneal lavage
Molecular Immunogenetics
18. The Appendix - Acute Appendicitis
The Very Young
Diagnosis may be more difficult to establish, WBC is
likely to be normal
(12% are normal).
Children are more likely to progress to perforated
appendix
(? Under-developed Greater Omentum).
Molecular Immunogenetics
19. The Appendix - Acute Appendicitis
The Very Old
Greater morbidity and mortality
Less typical presentation
Cancer may be a possibility as an underlying
cause.
Perforation of 50% and mortality of 20% has been
reported
Molecular Immunogenetics
20. The Appendix - Acute Appendicitis
The Pregnant
Implications: Clinical Findings, Lab Ix, SurgeryImplications: Clinical Findings, Lab Ix, Surgery
1: 2000 pregnancies.
More common in the first two trimesters
The appendix is pushed superiorly and laterally
WBC > 15
Premature Labor 10-15% with surgery
Perforated appendix leads to fetal death in 20%
Rapid diagnosis and treatment is advised.
Molecular Immunogenetics
21. The Appendix - Acute Appendicitis
In AIDS Patients
Be aware of CMV or Kaposi sarcoma as the
underlying cause
WBC may not rise
Molecular Immunogenetics
22. The Appendix - Acute Appendicitis
The Management
Preop:
IVI,
analgesia,
IV antibiotics
Conventional appendicectomy
Types of incisions
Laparoscopic appendicectomy:
(questions regarding pain, hospital stay, operation time,
to daily activity, wound infection)
Molecular Immunogenetics
24. The Appendix - Acute Appendicitis
Post-Operative
1. Check the vitals
2. Check the abdominal signs and bowel
movement
3. Check the wound
4. Advise on mobilization
5. In OPD:
1. Check wound
2. Check the Histology
Molecular Immunogenetics
25. The Appendix - Acute Appendicitis
Prognosis
Mortality: from 0.2% to 1%
Complications increase with perforation
Morbidity:
Wound abscess,
Wound infection (less with MacBurney’s incision),
Wound dehiscence
Intra-abdominal abscess,
Faecal fistula,
Intestinal obstruction,
Adhesive band,
inguinal hernia.
Fertility
Molecular Immunogenetics
27. The Appendix - Acute Appendicitis
Problems
Mass palpable pre-operatively
Appendix is normal at operation
Tumor is found in appendix
Prophylactic appendicectomy
Molecular Immunogenetics
28. The Appendix – Chronic Appendicular Conditions
Chronic Appendicitis
A loose term referring to a multitude of
conditions associated with RIF pain and in which
pathology of the appendix has been found.
Molecular Immunogenetics
29. The Appendix – Chronic Appendicular Conditions
Appendicular Mass
Results from either:
1. Localized by edematous, adherent omentum and
loops of small bowel
2. Appendicular abscess
Incidence is 10%
Higher in children
Management controversy:
Interval vs Immediate appendicectomy
Molecular Immunogenetics
30. The Appendix – Chronic Appendicular Conditions
Tumors of The Appendix
Carcinoid:
Arise from Kluchitsky cells
Mean age 20-40
Yellow bulbar mass
In F>M
In third decade of life
Usually lies near the tip
In the absence of LN spread with <2 cm in diameter
appendicectomy is sufficient. Otherwise a R
hemicolectomy is necessary.
Adenocarcinoma and Lymphoma.
Molecular Immunogenetics
31. Molecular Immunogenetics
Referance
•Ajmani ML, Ajmani K (1983). the position length and arterial supply of
vermiform appendix. Anatomisecher Anzeiger 153(4): 369-374
•Al-fallouji MM, Mchbrien MP (1993). Appendectomy in Al-fallouji MA
Mebrien MP (edn) Evolution of some important surgical procedures
Headway press, Great Britain pp.273.
•Badoe EA (1994). The appendix: in Badoe EA Achampong E, Jaja MO
(editors) Principle and Practice of surgery including pathology in the
tropics, second edn. Tema Ghana publishing corporation 1199-501.
•Bakheit MA, Warille AA (1999) Anomalies of the vermiform appendix and
Prevalence of acute appendicitis in Khartoum East Afr med. j.,
1616:336-340.
•Balteazar EJ, Gade M (1976). The normal and abnormal development of
appendix Radiology 121:599 -604
•Birnbaum BA Wilson SR (2000). Appendicitis at the millennium, radiology
215:337-348