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Difference between revisions of "Acute appendicitis"
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| Prognosis = good | | Prognosis = good | ||
| Other = | | Other = | ||
| ClinDDx = symptomatic [[Meckel diverticulum]], epiploic appendagitis, [[ectopic pregnancy]], ruptured ovarian cyst, [[ovarian torsion]], pelvic inflammatory disease, benign fecal impaction | | ClinDDx = symptomatic [[Meckel diverticulum]], [[epiploic appendagitis]], [[ectopic pregnancy]], ruptured ovarian cyst, [[ovarian torsion]], pelvic inflammatory disease, benign fecal impaction | ||
}} | }} | ||
'''Acute appendicitis''', abbreviated '''AA''', is an acute inflammation of the [[vermiform appendix]]. It is very common and keeps general surgeons busy. | '''Acute appendicitis''', abbreviated '''AA''', is an acute inflammation of the [[vermiform appendix]]. It is very common and keeps general surgeons busy. | ||
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**Approximately of 40% colectomies for CD (that include an appendix) have involvement of the appendix.<ref name=pmid11956821>{{Cite journal | last1 = Stangl | first1 = PC. | last2 = Herbst | first2 = F. | last3 = Birner | first3 = P. | last4 = Oberhuber | first4 = G. | title = Crohn's disease of the appendix. | journal = Virchows Arch | volume = 440 | issue = 4 | pages = 397-403 | month = Apr | year = 2002 | doi = 10.1007/s004280100532 | PMID = 11956821 }}</ref> | **Approximately of 40% colectomies for CD (that include an appendix) have involvement of the appendix.<ref name=pmid11956821>{{Cite journal | last1 = Stangl | first1 = PC. | last2 = Herbst | first2 = F. | last3 = Birner | first3 = P. | last4 = Oberhuber | first4 = G. | title = Crohn's disease of the appendix. | journal = Virchows Arch | volume = 440 | issue = 4 | pages = 397-403 | month = Apr | year = 2002 | doi = 10.1007/s004280100532 | PMID = 11956821 }}</ref> | ||
*[[Crypt cell carcinoma]] (goblet cell carcinoid) - may be subtle. | *[[Crypt cell carcinoma]] (goblet cell carcinoid) - may be subtle. | ||
*[[Interval appendectomy]] - may have active inflammation - [[clinical history]] is essential to differentiate.<ref>{{cite journal |authors=Malvar G, Peric M, Gonzalez RS |title=Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis |journal=Histopathology |volume=80 |issue=6 |pages=965–973 |date=May 2022 |pmid=35076982 |doi=10.1111/his.14621 |url=}}</ref> | |||
===Images=== | ===Images=== | ||
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===Micro=== | ===Micro=== | ||
====Gangrenous appendicitis==== | ====Gangrenous appendicitis==== | ||
The sections | The sections show appendiceal wall with marked acute transmural inflammation and necrotic appendiceal wall with large collections of neutrophils. Several medium-sized blood vessels are thrombosed. A thick layer of neutrophils cover the serosal aspect. | ||
=====Alternate - less developed===== | =====Alternate - less developed===== | ||
The sections | The sections show appendiceal wall with marked acute inflammation and a focally | ||
necrotic appendiceal wall with large collections of neutrophils. Intravascular fibrin | necrotic appendiceal wall with large collections of neutrophils. Intravascular fibrin | ||
is seen in medium-sized blood vessels. Clusters of neutrophils are seen on the serosal | is seen in medium-sized blood vessels. Clusters of neutrophils are seen on the serosal | ||