The appendix is a vestigial organ attached to the cecum. It varies in length from 7.5-10cm and is lined with colonic mucosa. The blood supply comes from the appendicular artery, a branch of the ileocolic artery. Appendicitis occurs due to obstruction of the appendix leading to bacterial overgrowth and inflammation. The most common presentation is migratory periumbilical pain that increases in the right lower quadrant with rebound tenderness. A CT scan can confirm the diagnosis but it is usually diagnosed clinically using Mantrel's criteria. Treatment involves antibiotics and bowel rest or an appendectomy if surgery is required.

2.  • Vermiform appendix is vestigial organ
It is a blind-ended muscular tube
containing mucosa, submucosa,
muscular layer and serosa attached to the
posteromedial wall of caecum, about 2cm
below ileocaecal junction.

3.  MEASUREMENTS • The appendix
varies in length between 7.5 – 10cm.
 EPITHELIUM : It is lined by columnar
cell intestinal mucosa of colonic type

4.  SURFACE ANATOMY • The base of appendix
is represented by a point about 2cm below the
intersection between the transtubercular and rt
lateral planes.
 McBurney’s point

6. 1) Retrocecal 74 %
2) Pelvic 21%
3) Subcecal 1.5 %
4) Paracecal 2%
5) Preileal 1%
6) Postileal 0.5%
7) Subileal

7. BLOOD SUPPLY : The blood supply of appendix
is appendicular artery, it’s a terminal branch of
ileocolic artery clinical pearls : appendicular artery
is an end artery thrombosis of which leads to
necrosis of appendix ( gangrenous appendix)
NERVE SUPPLY : Sympathetic fibers from T10
spinal segment therefore in appendicitis
visceral pain is referred to umbilicus
LYMPHATIC DRAINAGE : The lymphatic
drainage is by superior mesenteric nodes.

8.  ETIOLOGY: Appendicitis is clearly
associated with bacterial proliferation
within appendix. No single organism is
responsible but many aerobes and
anaerobes are responsible
 feacolith( appendicolith) :it is
composed of inspissated faecal material,
calcium phosphate, bacteria and epithelial
debris

9.  Stricture : A fibrotic stricture of the
appendix
 Tumor : particularly carcinoma of
caecum
 Parasites : oxyuris vermicularis

10.  Obstruction inflammation
lymphoid hyperplasia edema and
ulceration of wall bacterial
translocation to submucosa
distension of appendix venous
obstruction ischemia ACUTE
APPENDICITIS

11.  SIGN AND SYMPTOMS: Anorexia,
fever , periumblical pain with RLQ
tenderness. Elevated white count with
left shift

12.  M : Migratory pain to left
 A : Anorexia
 N : Nausea and vomiting
 T : tenderness at RLQ
 R : Rebound tenderness
 E : Elevated temperature
 L : leucocytosis
 S : Shift of WBC to left

13. DIAGNOSTIC TEST : Usually diagnose
clinically using mantrels score. But CT Scan is
most accurate test to perform.
TREATMENT :
conservative : bowel rest, hydration, IV
antibiotics ( metronidazole + 3rd generation
cephalosporin )
Surgery : Appendectomy