Fast Five Quiz: How Much Do You Know About Appendicitis?

Jaime Shalkow, MD

Disclosures

December 09, 2016

An inflamed or perforated appendix can be walled off by the adjacent greater omentum or small-bowel loops, resulting in phlegmonous appendicitis or focal abscess.

In suppurative appendicitis, increasing intraluminal pressures eventually exceed capillary perfusion pressure, which is associated with obstructed lymphatic and venous drainage and allows bacterial and inflammatory fluid invasion of the tense appendiceal wall. Transmural spread of bacteria causes acute suppurative appendicitis. When the inflamed serosa of the appendix comes in contact with the parietal peritoneum, patients typically experience the classic shift of pain from the periumbilicus to the RLQ, which is continuous and more severe than the early visceral pain.

In perforated appendicitis, persisting tissue ischemia results in appendiceal infarction and perforation. Perforation can cause localized or generalized peritonitis.

For more on the stages of appendicitis, read here.

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