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CHRONIC APPENDICITIS Srijana Jaisi MBBS 4 th Year Anatomy of Appendix Blood Supply •Vestigial Organ •Role in immune system: –The appendix is experimentally verified as being rich in infection-fighting lymphoid cells, suggesting that it might play a role in the immune system Appendicitis •Inflammation of Vermiform Appendix •Chronic Appendicitis •Acute Appendicitis
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CHRONIC APPENDICITIS
Srijana JaisiMBBS 4th Year
Anatomy of Appendix
Blood Supply
Function
• Vestigial Organ• Role in immune system:– The appendix is experimentally verified as being
rich in infection-fighting lymphoid cells, suggesting that it might play a role in the immune system
Appendicitis
• Inflammation of Vermiform Appendix
Types
• Acute Appendicitis
• Chronic Appendicitis
Chronic AppendicitisDefinition
• Recurrent Inflammation of Vermiform Appendix.
Causes• Partial obstruction of
appendix by calculous, feces, Lymph node etc.
• Inflammation and compromised blood supply to appendix
• Internal Bacterial Infection
Signs and Symptoms
• Abdominal Pain• Fatigue• lethargy• Change in bowel habit
Basic difference from Acute Appendicitis
• Mild Symptoms• Slow progression• Longer duration ( Months)
Differential Diagnosis
Males• Diverticulitis• Colitis• Cystitis• Pyelonephritis• Nephrolithiasis• Inflammatory Bowel
Disease• Irritable bowel Syndrome
Females• Same as in males and • Pelvic Inflammatory Disease• Chronic Ectopic Pregnancy• Endometritis• Ovarian Cyst
Diagnosis
It’s very challenging
• By the time we are able to make successful diagnosis, bacteria may have slowly spread throughout the body's internal organs. Since , there is no specific symptom , chronic appendicitis can go on undetected, which in time can lead to serious complications .
Management
• Conservative: – Supportive Therapy• IV Fluids
– Specific Therapy• Antibiotics ( Cefoxitin/
Ampicillin/Gentamycin/Metronidazole
Because of relapsing nature a constant and long term antibiotic therapy is required.
• Surgical Management– Laparoscopic Appendectomy
• Management of Complications– Abscess Drainage– Perforation Laparotomy
Conclusion
• Chronic Appendicitis is a potentially serious and diagnostically challenging condition which may have dreadful and fatal compications.
• So, we have to keep in mind chronic appendicitis as a differential diagnosis whenever a patient comes to the hospital with above mentioned symptoms.
Thank You
