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Appendicitis

Appendicitis Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix[1]. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly due to peritonitis and shock.[2] Reginald Fitz first described acute appendicitis in 1886,[3] and it has been recognized as one of the most common causes of acute abdomen pain worldwide.

Causes

Location of the appendix in the digestive systemObstruction of the appendiceal lumen has been attributed to a number of common sources including from fecaliths (a hard mass of fecal matter), normal stool, viral induced ulcers, or lymphoid hyperplasia. Once this obstruction occurs the appendix subsequently becomes filled with mucus and distends, increasing intraluminal and intramural pressures, resulting in thrombosis and occlusion of the small vessels, and stasis of lymphatic flow. As these progress, the appendix becomes ischemic and then necrotic. Rarely, spontaneous recovery can occur at this point. As bacteria begin to leak out through the dying walls, pus forms within and around the appendix (suppuration). The end result of this cascade is appendiceal rupture causing peritonitis, which may lead to septicemia and eventually death.

A number of environmental factors involving diet and hygiene have been proposed to be alternate causes of appendicitis, none of which has been studied in detail. According to the Medical Journal of Australia, "Dietary theories, notably an inadequate fibre intake, have been advanced to account for the geography of the disease, but it is clear that diet can not fully explain the epidemiology." [4]

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