Definition

An appendix is a continuation of a body. Appendix vermicular or ileo-caecal Appendix (which is called improperly appendix) is an invagination finger glove of starter of the large intestine (cecum), located part right abdomen. Appendicitis is inflammation of the Appendix vermicular.

Classification

There are other varieties of Appendix in the body:

• Appendix of Morgagni is located in the larynx to the level of the vocal cords.
• Xyphoid is located at the lower end of sternum (bone articulated with the anterior part of the coast in front of the chest)
• Omental appendices are greasy strips extending a meso, i.e. a membrane of the abdominal cavity.

Physiology

It is at the junction between the small intestine and large intestine, at the level of the cecum, vermiform appendix. It presents approximately cylindrical in shape and measures approximately 7 to 10 cm long and 4 to 8 mm in diameter.Ileo-caecal Appendix is rich in lymphoid follicles (elements essential to the defence of the body) and paradoxically it does not appear that he plays a very important role on the immune level in humans.

Causes

Classic appendicitis is characterized by blue tongue inflammation (inflammation with abundant secretions) or accompanied by pus.

Symptoms

• Pain of abrupt onset in the right iliac Fossa (part located to the right and below the umbilicus)
• Nausea and sometimes vomiting
• Sometimes constipation
• Moderate (about 38 to 38.5 ° C) fever

Consultation doctor

By palpation, medical examination shows that the area was painful and sometimes there has been a defensive response by a hardening of the wall of the abdomen.Touch rectal, carried out with extreme caution (with the little finger in children), causes pain located at the end of the finger and corresponding to inflammation in the left iliac fossa.

Medical analysis

The elevation of a variety of white blood cells (leukocytes). However, other conditions are likely to be the source of the WBC.

Medical examination

Ultrasound and the scanner of the abdomen are sometimes useful for the diagnosis.

Evolution of the disease

The crisis of appendicitis is likely to calm down first. This represents one of the reasons for which the diagnosis is not always quickly. The risk of re-offending are frequent.Chronic appendicitis (extending in time) is possible, mainly in certain elderly.

Complications of the disease

Plastic peritonitis: agglutination of intestinal loops are welded by adhesions (commonly) around the abscess. This occurs when the mucous membrane (layer of cells covering the inside of the vermiform appendix) is obstructed by pus. In this case, it remains localized and causes agglutination of intestinal loops.Appendicular peritonitis sometimes complicates the course in an old man, in an individual with a metabolic imbalance (diabetes, obesity) or in a poorly fed subject.

Differential diagnosis

Appendicitis is sometimes confused with:

• In children, mundane pain without cause determined
• A genital infection in women
• Urinary tract infection
• A tumor of the caecum
• A mesenteric adénolymphite which is an inflammation of the mesenteric lymph nodes (lymph nodes near the intestines).

Treatment

The appendectomy, which consists of the removal of the Appendix vermicular, will happen when there are symptoms significant as a fever around 38 ° C, a reaction of defence (see above) at the level of the abdomen, a rise in free WBC blood analysis.Intervention is often done in emergency because it is necessary to avoid a complication such as plastic peritonitis (see complications).In the presence of actual appendicitis, antibiotic administration can only represent a further danger.When there is a peritonitis plastic, it is necessary to immediately evacuate the abscess (but sometimes, this is done later). In the presence of a generalized peritonitis, emergency response is necessary and includes the removal of the Appendix and complete cleaning of the whole of the cavity of the abdomen.