Acute appendicitis

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A 10 yr old girl was admitted to the emergency service at NUH with a 3 day history of right iliac fossa pain associated with fever.  She was nauseous and vomited several times.  Examination revealed severe abdominal tenderness.  On auscultation, the medical officer could hear no bowel sounds.  The girl was taken to the operation theatre and a resection was carried out.

1.    Which is the organ in the section?

       Appendix

2.    Why is this section abnormal?  Describe abnormal histological features.

            Ulceration of the mucosa with purulent exudates entering the lumen

            Destruction of the original mucous glands

            Large numbers of neutrophils within the submucosa and mucosa

            Smooth muscle fibres are separated by inflammatory oedema, severe         inflammation can result in extensive necrosis of the muscle layer

3.    True-False MCQs:

       The main cause of this condition is obstruction T

       This condition carries a death risk T

       The main cause of this condition is the release of interleukins and the           TNF secondary to bacterial infection. T

       All the above are true       

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Copyright � Joseph Ong 2003