Variations of the position of the appendix

Position variations of the appendix:

Regular
Paracecal: To the right of the appendix
Retrocal: Behind the appendix, resting on the iliopsoas muscle
Paraileal: Turned up towards the ileum
In the small basin: very long appendix, reaching into the small basin
Caecal depression: The appendix and appendix are located in the small pelvis
Caecal elevation: The appendix and appendix are located in the right upper abdomen
(pregnancy)
Situs inversus: Very rare anomaly of the human body, in which all organs lie mirror-inverted in the body. The appendix is thus located in the left lower abdomen.

Course of appendicitis

The typical appendicitis can be divided into inflammatory stages: 1. catarrhal stage: the appendix is swollen, reddened and painful. No pus develops yet and this stage is still fully reversible (reversible). 2. seropurulent satdium: this is a transitional stage between 1 and 3 3. destructive stage: 3 stages are distinguished: If there is an obstruction in the appendix, the secretions and feces will build up in it.

The appendix swells, turns red and the first painful event occurs. In a period of 12-24 hours the first symptoms of appendicitis develop. The bacteria in the appendix can then multiply strongly in the standing secretion.

Due to the swelling of the appendix, the blood vessels are gradually squeezed, resulting in an oxygen deficiency for the tissue. The tissue slowly dies and the bacteria can break through the mucosal barrier. If, after about 48 hours, they also migrate through the last layer of the intestinal wall, the serosa, the surrounding peritoneum becomes infected (periappendicitis, local peritonitis) and can then spread throughout the entire peritoneum.

Appendicitis ulcerophlegmonosa: The mucous membrane shows ulcers. Beginning of tissue destruction. – Appendicitis empyematosa: pus forms in the appendix
Appendicitis gangrenosa: The appendix dies slowly. A gangrene develops (tissue death).

Complications

Appendicitis is a life-threatening disease and should be diagnosed and treated as soon as possible. Some serious complications can arise if the diagnosis of appendicitis is delayed. – Free perforation: If the intestinal wall is damaged and there is severe swelling, the appendix wall can break through and the contents can enter the abdominal cavity (peritoneum).

The bacteria released in this way can cause severe diffuse peritonitis. – Perityphlitic abscess: If the perforation cannot spread any further due to surrounding adhesions, a pustule develops in the vicinity of the worm’s foot. – Conglomerate tumor: This is not a real tumor (“cancer“).

The inflammation can cause the surrounding structures, such as the appendix, large network (omentum majus) and small intestine loops to adhere to a tumour. – Abscesses: If pus is formed in the abdominal cavity, encapsulated abscesses (pus cavities) can develop. Predestined sites for abscesses are between the loops of the small intestine (interenteric), under the (diaphragmatic subphrenic), under the liver (subhepatic) and especially in the so-called Douglas space.

In women, this space lies between the rectum and the uterus. – Thrombophlebitis of the portal vein: When the inflammation of the peritoneum spreads to the portal vein system, an inflammation of the veins (phlebitis) develops, which is often accompanied by thrombus formation in the portal vein. – Paralytic ileus: An inflammation of the abdominal cavity (peritonitis) can lead to a paralysis of the intestine. As a result, intestinal movements (peristalsis) can no longer be performed. This results in a transport stop of the intestinal contents, a so-called ileus.