Appendix

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Velsundar
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Posts: 21
Joined: Mon Oct 23, 2017 12:51 pm

Appendix

Post by Velsundar » Mon Oct 23, 2017 1:38 pm

Appendix
caecum-appendix-ileum-illustration-antoine-micheau-imaios-en_medical512.jpg
caecum-appendix-ileum-illustration-antoine-micheau-imaios-en_medical512.jpg (65.63 KiB) Viewed 110 times
Definition
Is a vestigeal organ, a tubular structure of about 5 cm with a lumen
It is attached to the caecum
Situation
In the right iliac fossa
McBurney's point corresponds to the base of appendix - a point which is the
junction of lateral 1/3 and medial 2/3 of a line which is drawn from the umbilicus to the
anterior superior iliac spine.

Features of the appendix
Found at the point where the three taeniae coli converge on the postero medial wall of the caecum
It opens into the caecum at one end and the other end is blind
The taeniae coli merge into a complete longitudinal muscle layer over the appendix
Mesoappendix : a peritoneal fold enclosing the appendicular vessels.
It is a prologation of the mesentery of the terminal ileum.
It contains the appendicular artery - a branch of the posterior caecal artery
The position of the appedix in relation to the caecum and terminal ileum is variable

Structure
Varies considerably in length and circumference
The lumen is narrow may admit a match stick
Peritoneal layer - adventitia
Muscular coat
Longitudinal and circular (outer and inner layers) muscle layer
Submucosa
Has a well developed submucous coat containing lymphoid follicles
The lumen has longitudinal folds of mucous membrane

Blood supply
Appendicular artery a branch of ileo- colic artery
Appendicular vein drains into ileo-colic vein portal vein

Applied Anatomy
Inflammation of the appendix → Appendicits
During inflammation : tenderness → in the McBurney's point.

Various positions of the appendix
1.Preileal
2.Post ileal
3.Retrocaecal
4. Subcaecal
5. Pelvic
various positions of appendix.jpg
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Dr.VKV M.S.
Posts: 6
Joined: Mon Oct 23, 2017 3:28 pm

Re: Appendix

Post by Dr.VKV M.S. » Mon Oct 23, 2017 4:31 pm

There are some interesting clinical facts about the inflammation of the appendix.
Pre-ileal and post-ileal appendix may present many times as only diarrhoea, fever and vomiting because of its proximity to the terminal ileum.

Post caecal appendix is protected by a gas filled caecum in front. So pain on palpation may be minimal or totally lacking.

Subhepatic appendix may present with features of cholecystitis.

Pelvic appendix may present with features of urinary tract infection or diarrhoea.

Chronic appendicits may present with only a colicky pain of the abdomen with no signs of inflammation. USGM reports may call it normal. (deceptive). Hence doctor's decision is more important than "machine's" decision. Do not depend solely on the ultrasound report.

Appendicitis is many a time interpreted as peptic ulcer by many practitioners.

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