Acute appendicitis
Epidemiology
- Peak incidence: 10–19 years of age
Etiology
Pathogen
- E. coli (most common)
- Bacteroides fragilis (second most common)
Causes
- Caused by obstruction of the appendiceal lumen due to:
- Lymphoid tissue hyperplasia (60% of cases): most common cause in children and young adults
- The lamina propria and submucosa of the appendix have an abundance of lymphoid follicles. Hyperplasia of these follicles may be physiological (e.g., during childhood and adolescence, when lymphoid tissue is developing and maturing) or pathological (e.g., secondary to an infectious or inflammatory process within the bowel).
- The lamina propria and submucosa of the appendix have an abundance of lymphoid follicles. Hyperplasia of these follicles may be physiological (e.g., during childhood and adolescence, when lymphoid tissue is developing and maturing) or pathological (e.g., secondary to an infectious or inflammatory process within the bowel).
- Appendiceal fecalith (concretion of feces that develops in the appendix that can obstruct the appendiceal lumen) and fecal stasis (35% of cases): most common cause in adults
- Neoplasm (uncommon): more likely in patients > 50 years of age
- Parasitic infestation
- Lymphoid tissue hyperplasia (60% of cases): most common cause in children and young adults
Pathophysiology
Clinical features
Diagnostics
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Treatment
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