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K25 Acute Appendicitis

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  GIS-K-25 ACUTE APPENDICITIS Appendiceal Mass / Abscess  INTRODUCTION   The appendix is : -Wormlike extension of the cecum (vermiform appendix). -Length is 8-10 cm (ranging from 2-20 cm). -Fifth month of gestation -Several lymphoid follicles.  Etiology: Obstruction  of the lumen appendix followed by infection    Catarrhal appendicitis. - lymphoid hyperplasia (60% children) -Gastro enteritis -Virus -Acute respiratory infection -Mononucleosis  Obstructive appendicitis -fecalith 35% adults. -foreign body / parasites (4%) - tumors (1%)    Pathophysiology  Wangensteen proposed 1.Closed loop obstruction 2.Increase in luminal pressure. 3.Exceeds capillary pressure causes mucosal ischemia 4.Luminal bacterial overgrowth and translocation bacteria across the appendiceal wall result : -Inflammation -Edema -Necrosis   perforation occur about 48 hours .  If the body successfully walls off the perforation Appendiceal Mass  If the perforation is not successfully walled off   Diffuse peritonitis will develop.
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