Vermiform process, with a segment removed, showing acute obstructive appendicitis caused by foreign bodies
GC.10067
Vermiform process, with a segment removed, showing acute obstructive appendicitis caused by foreign bodies.
From a 23 year old female, who twenty-four hours earlier had been awakened by abdominal pain. The pain, which from the first was localized to the right lower quadrant of the abdomen, recurred at intervals before becoming continuous.
At operation the appendix was found in the retrocaecal position (localised behind the cecum, which is a pouch connected to the junction of the small and large intestines). It was bound down at its mid point by an adhesion, and thus kinked. Its proximal half appeared normal; its distal half was swollen, congested, partly necrotic and covered by fibrinous lymph. There was no abscess formation.
In this specimen the appendix presents a stricture at its mid point. A concretion, impacted at the site of constriction, has obstructed the distal half and thus initiated the inflammatory change. The distal part (which contained faecal pus) is distended and somewhat thickened. Its mucous lining is necrotic. Its outer surface is congested and covered with flakes of lymph. The specimen is a typical example of acute obstructive appendicitis.
