Appendicitis 

Definition:-

Acute inflammation of the appendix is called appendicitis. This condition is seen more commonly in older children and young adults and in uncommonly at the extremes of age.

The disease is seen more frequently in the west and in affluent societies. With due to variation in diet- a diet with low bulk or cellulose and high protein intake more often to casuse appendicitis. 

Pathogenesis:-

The most common cause of the appendicitis is obstruction of the lumen from various etiological factors that leads to increased intraluminal pressure. This pressure presses the blood vessels and produce ischemic injury .and now this reason more prone to the bacterial proliferation and it cause inflammation in appendix and necrosis in severity.

The most common cause of the appendicitis is-

1. Intestinal lumen obstruction (may be prolonged constipation or microbiology infection)
2. Parasitic infection (Enterobious vermicularis)
3. Tumour formation 
4. Foreign body obstruction 
5. Blood vessels occulusion 
6. Hematogenous spreading of the infection  

Histological:-

Grossly :- The appearance depend upon the severity of the appendicitis. In " early acute appendicitis "the organ is swollen and serosa become hyperaemia. And in advance cases called "acute gangrenous appendicitis" there ulceration and necrosis of mucosa spread in the through out the wall and appendix become soft and friable . So bacteria can grow and cause greenish- black gangrenous necrosis . 

Microscopicslly:- The most important histopathological diagnostic criteria is the Neutrophilic infiltration of the muscularis ​​​​​​. Some other changes be also seen like congestion and oedema in the appediceal wall.

Clinical:-

The patient comes with some clinical complaints which are-

• Colicky pain (initially around the umbilicus reason later gets localised in right iliac fossa).
• Nausea and vomiting 
• Abdominal tenderness 
• Pyrexia and mild grade fever
• Increase pulse rate
• Loss of appetite 

Complication:-

If the condition is not adequately managed at the time then becomes complicated and body shows some symptoms as-

1. Peritonitis:- A perforated appendix can casuse peritoneum infection.

2. Appendix abscess:-This is due to rupture of appendix can cause localised abscess in "right iliac fossa " now this abscess may spread to other site such as between the liver and diaphragm and in pelvis sread between rectum and urinary bladder and in females uterus and fallopian tube also abscess.

3. Portal pylephlebitis- spreading of the infection through the mesenteric vein and causes abscess in other visceral organs ex.- liver abscess and lung abscess 

4. Adhesion:- late complication of the acute appendicitis are fibrous adhesion.

5. Tumour of appendix:- Tumour of the appendicitis are quite rare but carcinoid tumour is most common in appendix.

Treatment :-

The surgical removal of the appendix is very reliable treatment of Appendicitis. 

Appendectomy is the removal of the appendix is called appendectomy.