Most commonly affects those in their second or third decade; it is one of the most common causes of abdominal pain in young people and children
Pathophysiology
Typically caused by direct luminal obstruction, usually secondary to a faecolith, lymphoid hyperplasia, impacted stool or, rarely, an appendiceal or caecal tumour
When obstructed, commensal bacteria in the appendix can multiply, resulting in acute inflammation
Reduced venous drainage and localised inflammation can result in increased pressure within the appendix, in turn can result in ischaemia
If left untreated, ischaemia within the appendiceal wall can result in necrosis, which in turn can cause the appendix to perforate
Anatomy of pain localisation
Main symptom is abdominal pain - central pain that migrates to the right iliac fossa
Initial pain from the appendix and its visceral peritoneum is referred to the umbilical region
As the appendix becomes increasingly inflamed it irritates the parietal peritoneum, causing pain to localize to the right lower quadrant
McBurney's point refers to the point on the lower right quadrant of the abdomen at which tenderness is maximal in cases of acute appendicitis - it corresponds to the location of the base of the appendix when it lies in the retrocaecal position
Clinical features
Symptoms
Central pain that migrates to the right iliac fossa