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The Anatomy Of The Appendix Essay

3328 words - 14 pages

Dating back to the Renaissance, many scientists have taken special interest in the appendix, with the first drawings of the appendix in 1492 and later the first description of the appendix in 1521(Prystowsky, Pugh & Nagle, 2005). The function of the appendix in the adult human is still unclear, but it is likely related to the role of the lymphoid tissue in immunologic processes (Debas, 2004). It was not until 1711 that the first account of appendicitis was reported and then verified in an autopsy of a criminal (Prystowsky, Pugh & Nagle, 2005). In this account, appendicitis was described as a gangrenous appendix with a small perforation. Today, appendicitis is deemed as an inflammation of its ...view middle of the document...

The most common positioning of the appendix is in the right iliac fossa and is retroperitoneal; however, the position of the appendix varies from the right upper quadrant to the suprapubic region, which explains the different ways in which appendicitis presents itself (Clinical Review, 2011).
Acute appendicitis is the most common cause of abdominal pain and requires surgical treatment (Prystowsky, Pugh, & Nagle, 2005). There is a 6-7 percent chance of acquiring appendicitis throughout a person’s lifetime; however, the risk is most prevalent in adolescents and young adults, particularly males. Additionally, appendicitis is more common in industrialized nations, where a highly refined, low fiber diet is popular. Therefore, geographic variations exists due to the varying amount of dietary fiber in countries’ common diets. Dietary fiber is related to appendicitis because a lack of dietary fiber in a diet leads to harder stool, in turn causing higher intracolonic pressure, which has a part in the formation of fecaliths, which can obstruct the appendiceal lumen. With the knowledge of the importance of dietary fiber in a person’s diet in reducing the chances of getting appendicitis, there is a reduced incidence of appendicitis, likely due to the push for dietary fiber in industrialized countries’ diets. However, there is also an unproven theory that suggests the improvement in living standards and sanitation correlate with an increasing risk of appendicitis because the improvements in sanitation have led to less frequent exposure of young children to common enteric or respiratory infectious agents. Thus, the initial exposure to these infectious agents later in life induces a host response when prominent lymphoid aggregates are at their maximum, leading to obstruction and inflammation.
Luminal obstruction has been experimentally shown by Wangensteen and Dennis to be a cause in the development of acute appendicitis (Prystowsky, Pugh, & Nagle, 2005). The appendix is vulnerable to closed-loop obstruction followed by inflammation due to its small luminal diameter. Appendiceal obstruction is most commonly caused by fecal stasis and fecaliths, followed by lymphoid hyperplasia, which is associated with various disorders that include Crohn’s disease, gastroenteritis, amoebiasis, measles, mononucleosis, and other viral illnesses (Clinical Review, 2011). Other obstructions such as true appendiceal calculi, or hard, noncrushable, and calcified stones, are less common than appendiceal fecaliths, which are hard but crushable concretions. Although, due to their non-crushable nature, appendiceal calculi perforate the appendix more easily, making them more associated with perforating appendicitis and with periappendiceal abscesses (Birnbaum and Wilson, 2000). Vegetable matter and ingested seeds, intestinal worms, most prominently ascarids, and tumors, such as carcinoid are other proven luminal obstructions of the appendix causing appendicitis (Prystowsky, Pugh, &...

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