The Pathogenesis of Acute Appendicitis

Bohrod, Milton G.

doi:10.1093/ajcp/16.12.752

Cited by 23 publications

(12 citation statements)

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“…5,7 This is probably related to the extensive lymphoid tissue found in the appendix in this period of life, thus increasing its liability to obstruct and hence to become inflamed. 10,11 The male predominance found in the present study has been observed by others, 6,12 though female predominance has also been reported. 5,13 The striking seasonal variation in the incidence of acute appendicitis seen in this study is open to speculation.…”

Section: Discussionsupporting

confidence: 87%

Retrospective Study of Acute Appendicitis in Jordan

Al-Jitawi

1990

Ann Saudi Med

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Analysis of histopathological data obtained from 2264 emergency appendectomies performed in Jordan during 1975 to 1979 revealed a diagnostic accuracy rate of 61% ; 65% of the patients were in the second and third decades and the male to female ratio was 2.1:1.0. A seasonal variation of acute appendicitis with a peak in summer months was observed. The factors that may account for this variation will be discussed. SA Al-Jitawi, Retrospective Study of Acute Appendicitis in Jordan. 1990; 10(4): 426-428The high prevalence of acute appendicitis in Western countries is attributed to dietary habits.1 In Jordan, the quantity and variety of fresh fruits and vegetables are affected by seasonal variations. This study was carried out to assess the main epidemiological features of the disease, particularly in relation to dietary habits. Material and MethodsA total of 2264 appendectomy specimens were collected from the pathology files of Central Government Medical Laboratories, King Hussein Medical Centre, and Jordan University Hospital. These represent all cases of appendectomy performed in Amman during 1975 to 1979. Incidentally removed appendices were excluded. In each case a miniumum of three hematoxylin-eosinstained sections were reviewed. The polymorphonuclear leukocytic infiltration of the muscularis propria of the appendix was the histological criterion adopted for the diagnosis of acute appendicitis.2 Each patient was categorized on the basis of age, sex, and date of operation. A list of the quantity and kind of fresh fruits and vegetables consumed in the Amman area was obtained from the Statistics Department, Ministry of Agriculture, Jordan.

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Section: Discussionsupporting

confidence: 87%

Retrospective Study of Acute Appendicitis in Jordan

Al-Jitawi

1990

Ann Saudi Med

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“…Lymphoid hyperplasia and appendicitis have been documented in a number of communications over the past decades, and in this regard, in an article dealing with the pathogeneses of acute appendicitis written in 1946 by Bohrod [1], it was stated that "the attack of acute appendicitis follows obstruction of the appendix and the most common cause of obstruction is lymphoid tissue of the appendix, a structure capable of rapid change under stimulation." In further support of lymphoid hyperplasia being a significant factor in appendicitis, it was stated in "Pathology of Infancy and Childhood" by Kissane [2] that "the abundant lymphoid tissue in the juvenile appendix may become hyperplastic and mechanically obstruct the lumen [2].…”

Section: Discussionmentioning

confidence: 99%

“…The blood supply to the appendix is from its base to its tip with the tip being the most distant destination. As a result, if blood supply were to be compromised for any reason, the tip would be most vulnerable, and then hemorrhage, necrosis, and secondary bacterial invasion would lead to purulent appendicitis [1][2][3]. Indeed, this is another example of the compartment syndrome where constrictive/compressive factors lead to pressure-induced ischemia and its consequential hemorrhage and necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, there was no concerted effort to explain why purulent appendicitis would occur when no fecalith was present. However, upon review of the literature, lymphoid hyperplasia secondary to viral infection repeatedly surfaced [1][2][3][4][5][6][7][8][9][10], and it was for this reason that we undertook our sample study. We now wish to present the imaging and pathologic findings in these patients and suggest a pathophysiologic mechanism for the occurrence of non-fecalithinduced appendicitis.…”

Section: Introductionmentioning

confidence: 99%

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Non-fecalith-induced appendicitis: etiology, imaging, and pathology

et al. 2015

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This study aims to document the imaging and pathology findings in non-fecalith-induced appendicitis. We reviewed the imaging and pathologic findings in 40 patients with histologically proven purulent appendicitis seen over a 2-year period. Findings documented were (1) total appendiceal involvement, (2) predominant appendiceal tip involvement, (3) presence of a fecalith, and (4) presence of lymphoid hyperplasia. There were a total of 40 patients, 28 males and 12 females. The age range was 2-18 years with a mean of 11.5 years. Twenty-two (55 %) patients demonstrated classic purulent appendicitis of the whole appendix, 20 (91 %) of these appendices had a fecalith. Eighteen (45 %) patients demonstrated purulent appendicitis confined to or predominately involving the tip of the appendix, and all 18 (100 %) patients demonstrated marked lymphoid hyperplasia. Only two (11 %) of these appendices had a fecalith. Overall, a fecalith was found in only 55 % of our cases, while 45 % demonstrated no fecalith, but rather marked lymphoid hyperplasia. Lymphoid hyperplasia appeared to be the underlying predisposing cause of purulent appendicitis in these cases.

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“…In the of uncomplicated appendicitis is at age 15, and this has been depressed to the observed age of 12 by the addition of a proportion of cases of mesenteric adenitis. This suggestion is supported by the occurrence of the maximum frequency of cases of i and Watkins, appendicitis confirmed by histological examination ,of appendicitis in the age group 15 to 19 (Bohrod, 1946;Green and ildren (Fig. 1).…”

Section: Tis Appears Tomentioning

confidence: 60%

The influence of sex and age on appendicitis in children and young adults

Lee¹

1962

Gut

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SYNOPSIS A study has been made of the influence of age and sex on the incidence of cases of appendicitis and of fatal appendicitis in children and young adults. Appendicitis is uncommon in children under the age of 5, but the proportion of cases complicated by peritonitis is large, and the death rate in the population of this age is relatively high. Appendicitis is very common in adolescents, but here the proportion of cases complicated by peritonitis is small. However, because of the frequency of the condition, the death rate in the general population of this age is high, with a maximum at about the age of 15 years.These findings are compatible with the suggestion that the appendix during the 'teens is particularly liable to obstruct and hence to become inflamed because of the large proportion of lymphoid tissue which it contains.Inflammation of the appendix is more common in males than in females, and this male excess is greater in infants and pre-school children than it is in children of school age.

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The Pathogenesis of Acute Appendicitis

Cited by 23 publications

References 0 publications

Retrospective Study of Acute Appendicitis in Jordan

Retrospective Study of Acute Appendicitis in Jordan

Non-fecalith-induced appendicitis: etiology, imaging, and pathology

The influence of sex and age on appendicitis in children and young adults

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