2. Acute appendicitis
• Acute appendicitis is a nonspecific bacterial
inflammatory disease of the appendix of the caecum.
• This is the most common disease of the appendix.
• The number of sick people is - 300-500 from 100 000
population per each year.
• The most common acute appendicitis occurs at the age
of 20 to 40 years, women get sick 2 times more often
than men. Mortality from the disease 0,1-0,3 %,
• Post operating complications are - 5-9 %.
3. Classification
by V.S. Saveliev (1995)
1. Acute appendicites,
2. Suppurative acute appendicitis :
a) Suppurative
b) Suppurative- ulcerous
3 Gangrenous/necrotizing
appendicitis :
a) primary gangrenous
b) secondary gangrenous
4. Surgical anatomy
-The appendix is attached
at the point of
convergence of the three
taeniae coli of the
caecum on its
posteromedial wall
- The mesentery of the
appendix containing fat
& appendicular artery
and vien
5. Type of location of the
appendix
1 – Post ileal (1%)
2 – Retrocaecal (63%)
3 – pelvic (33%);
4 – pre- ileal (1%);
5 – Subcaecal (1%)
6. Variants of the location of the
vermiform appendix (depend on the
gestational age)
8. 2. Infective agents
• Primary infection leading to lymphoid
hyperplasia
• Secondary infection caused by pressure of an
obstructed agent leads to epithelial erosion and
bacteria gain access to the wall
18. Conclusions
• All patients with suspected acute appendicitis should be hospitalized for
dynamic observation.
• In case of a doubtful diagnosis of appendicitis, video laparoscopy should
be used ̆.
• When establishing destructive forms of appendicitis and the presence of
local unlimited or diffuse purulent peritonitis, the abdominal cavity must
be drained.
