Appendicitis
Outlines ➢ General considerations ➢ Historical perspective ➢ Anatomy ➢ Pathophysiology ➢ Clinical findings ➢ Diagnosis ➢ Treatment
General considerations ● About 8% of people in Western countries have appendicitis at some time during their life, with a peak incidence between 10 and 30 years of age . ● Acute appendicitis is the most common general surgical emergency.(10%)
General considerations ● Acute appendicitis has protean manifestations. ● It may simulate almost any other acute abdominal illness and in turn may be mimicked by a variety of conditions. ● Progression of symptoms and signs is the rule —in contrast to the fluctuating course of some other diseases
Historical perspective ● Willard Packard performed the first surgery in 1867. ● In 1886,Reginald Fitz described the characteristic, clinical findings and pathology of the disease,identified the appendix as the primary cause of right lower quadrant inflammation. ● Fitz coined the term appendicitis and recommended early surgical treatment
Historical perspective ● In 1889, Chester McBurney described characteristic migratory pain as well as localization of the pain along an oblique line from the anterior superior iliac spine to the umbilicus. ● In 1894, McBurney described a right lower quadrant muscle-splitting incision for removal of the appendix
Historical perspective ● In the 1940s,the mortality rate from appendicitis improved with the widespread use of broad-spectrum antibiotics. ● In 1982, Laparoscopic appendectomy was first reported by the gynecologist Kurt Semm but has only gained widespread acceptance in recent years
Anatomy ＆ physiology ● The base of the appendix is located at the convergence of the taeniae(3) of colon. ● This anatomic relationship facilitates identification and location of the appendix at operation
