Additional information on Appendicitis can be found in Part One - All About Appendicitis.
APPENDICITIS is simply defined as the inflammation of the appendix, a finger shaped pouch projecting out of the colon on the lower right side of the abdomen, causing the lining of its walls to be filled with pus. Though the term for this medical condition was in use since 1885 it was not until the English monarch Edward VII incurred appendicitis—which forced him to delay his coronation-- that it was incorporated into English dictionaries. In fact the anatomical name for the appendix—vermiform appendix—is translated as worm-like appendage because of its appearance as a closed-ended, narrow tube attached to the cecum or the first part of the colon like a worm.
As its function, the wall of the appendix—like the colon—contains a layer of muscle and houses lymphatic tissue that forms part of the body’s immune system for producing anti-bodies. Usually the opening or inner lining of the appendix produces a small amount of mucus which flows through the appendix and into the cecum. When inflammation occurs the opening into the cecum gets blocked due to either a thick build-up of mucus within the appendix or stool entering the appendix from the cecum.
Eventually the mucus or stool hardens to rock-like conditions called fecalith—literally means a rock of stool.
Appendicitis also occurs when the lymphatic tissue in the appendix swells and blocks the appendix. When this happens bacteria normally found within the appendix then infects the appendix wall, causing the body to responds by attacking the bacteria thus causing inflammation.
Experts cite an alternative theory on the cause of appendicitis which is said to originate from an initial rupture of the appendix followed by the spread of bacteria outside of it. Though its cause is unclear it may involve changes within the lymphatic tissue lining the wall of the appendix. As the inflammation spreads through the appendix walls, a rupture occurs causing the infection to spread through the abdomen. Still, the infection is usually confined to a small area surrounding the appendix, usually in the form of an peri-appendiceal abscess.
Mild cases of appendicitis are usually resolved without treatment but severe cases require the removal of the inflamed appendix. The removal can be facilitated either through laparotomy—a surgical incision through the abdominal wall to access the abdominal activity--or laparoscopy, a surgical procedure involving an incision on the navel which allows the insertion of a viewing tube or laparoscope. If left untreated, the condition is fatal due to peritonitis and/or shock.
Causes of Appendicitis
Though its nature is unknown doctors agree that appendicitis is usually caused by the obstruction of the appendiceal orifice or opening. The blockage may be inflicted by fecal matter trapped in the appendix, the thickening of mucous, a small tumor caused by a carcinoid or a small blood clot.
Viral infections that inflict ulcerations in the linings can also obstruct the appendix through proliferation of lymphatic tissue in its walls. This obstruction can lead to progressive appendiceal distension which increases pressure within the appendix and disrupts its blood supply. With this the appendix is disabled from counteracting infection and fecal bacteria grows out of control.
Even if the body can recover at times, the condition if left unchecked can cause the appendix walls to become gangrenous due to lack of blood flow. As bacteria begins to leak out, pus forms within and around the appendix walls through the process called suppuration.
This results in appendiceal rupture causing peritonitis— an acute or chronic inflammation of the peritoneum, a membrane lining the abdominal cavity and surrounds the internal organs. This in turn can lead to septicemia or severe infection of the bloodstream and eventually death.
