Title: Analysis of Patterns of Mucosal and Histopathological Changes in Cases of Acute Appendicitis
Authors: Dr R. Muthukrishnan, MD, Dr M. Malathi, MD, Dr S. Ravi, MD, M. Kishore Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.04
Abstract
Introduction
Acute appendicitis is the most common general surgical emergency. The lifetime risk for appendicitis is 7%, commonly occurring in adolescent and young adults[13]. In England, 42,526 patients underwent appendectomies in the year 2004–5, with a mean age of 28 years[10]. The rate of acute appendicitis varies among countries. In USA and Europe there is a declining rates of acute appendicitis[13]. In developing countries due to changes in life style there is increasing incidence in most urban centers[14]. Despite of advances in technology and imaging modalities, there is dilemma in the diagnosis of acute appendicitis, however histopathological examination still remains the gold standard for the confirmation of appendicitis[15], whether it is acute or chronic.
Acute appendicitis is defined as an inflammation of the inner lining of the appendix vermiformis, which then spreads to other parts of the organ. Various etiologies for this clinic-pathologic condition have been identified, but luminal obstruction is considered the most critical factor, as it triggers the inflammatory process. When lumen obstruction occurs, intraluminal pressure surpasses that in the appendiceal veins, causing venous outflow obstruction. Finally, ischemia develops in the appendiceal wall, which weakens the epithelial integrity and increases the organ's risk of bacterial invasion.
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