What makes an appendix gangrene

First Page Preview View Large. Access through your institution. Add or change institution. Save Preferences. Privacy Policy Terms of Use. Access your subscriptions. Free access to newly published articles. Purchase access. Rent article Rent this article from DeepDyve. Access to free article PDF downloads. The visceral afferent nerve fibres are stimulated, and the patient perceives mild visceral periumbilical or epigastric pain, which usually lasts hours. The inflammation spreads to the parietal peritoneum, the pain increases in intensity and becomes somatic in nature localized at "McBurney's point" in the RLQ.

Gangrenous appendicitis: Intramural venous and arterial thromboses ensue, resulting in gangrenous appendicitis. Appendicitis evolved to necrosis-colliquation leading to acute adhesions with small bowel loops: The pathogenesis generally begins with luminal obstruction. The phenomenon occurs as a result of total obstruction of the appendix, with infection by gas-forming organisms. But a gas-filled appendix may not therefore be a specific finding of gangrenous appendicitis because it can occur when the inflamed appendix remains in communications with the cecum and rarely as a normal variant.

The right diagnosis of gangrenous acute appendicitis is very important to address the patient to the most adequate surgical treatment; the mortality risk of acute but not gangrenous appendicitis is less than 0. Patients with appendicitis are generally treated with a laparoscopic approach but in case of gangrenous appendicitis a laparotomic operation is the treatment of choice.

Differential Diagnosis List. Final Diagnosis. References [1] Craig S. Case information. Figure 1 No title. Figure 2 No title. Results: Patients in Group 1 and Group 2 were similar, but more cases of simple appendicitis occurred in Group 2. Average LOS for gangrenous appendicitis patients decreased from 2. Only one gangrenous appendicitis patient required readmission, and one patient in each group developed a superficial infection; there were no postoperative abscesses.

Conclusions: Gangrenous appendicitis can be safely treated as simple appendicitis without increasing postoperative infections or readmissions. Type of study: Prognosis study.