Anatomy

Appendix extends from the posteromedial aspect of the cecum inferior to the ileocecal
junction. The appendix varies in length and has a short triangular mesentery, the meso-appendix,
which derives from the posterior side of the mesentery of the terminal ileum. The mesoappendix
attaches to the cecum and the proximal part of the appendix. The base of the appendix most often
lies deep to a point that is one third of the way along the oblique line joining the right anterior
superior iliac spine to the umbilicus (McBurney point) (Moore, 2015).

Figure . Appendix and its vascularization (Moore, 2015)

The position of the appendix is variable, but it is usually retrocecal (posterior to the cecum).
The location of the rest of the appendix may be:

- suspended over the pelvic brim in a pelvic or descending position;

- below the cecum in a subcecal location; or
- anterior to the terminal ileum, possibly contacting the body wall, in a pre-ileal
position or posterior to the terminal ileum in a postileal position (Moore, 2015;
Drake, 2015)
 Figure . Possible positions of the appendix (Drake, 2015)

The appendix is supplied by the appendicular artery, a branch of the ileocolic artery, and
ileocolic vein drains blood from the appendix. The nerve supply of the appendix derives from
sympathetic and parasympathetic nerves from the superior mesenteric plexus. The sympathetic
nerve fibers originate in the lower thoracic part of the spinal cord (T10–T12), afferent nerve
fibers from the appendix accompany the sympathetic nerves to the T10 segment of the spinal
cord, while the parasympathetic nerve fibers derive from the vagus nerves (Moore, 2015).

Definition

Appendicitis is defined as an inflammation of the inner lining of the vermiform appendix that
spreads to its other parts (Craig, 2017).

Etiology

Appendicitis begins with luminal obstruction that can be caused by:

 - Inspissated fecal material
- Lymphoid hyperplasia
- Ingested foreign body
- Parasites
- Tumors (Kliegman, 2015).

Epidemiology

Appendicitis is most common in older children, with peak incidence between the ages of 12
and 18 years; it is rare in children younger than 5 years of age (<5% of cases) and extremely rare
(<1% of cases) in children younger than 3 years of age. Perforation is more common in children
compared to adults, particularly in young children; with perforation rates is 82% for children
younger than 5 years and nearly 100% in infants (Kliegman, 2015).

Sumber:

Craig, S. (2017, January 19). Appendicitis. Retrieved November 21, 2017, from Medscape:
https://emedicine.medscape.com/article/773895-overview

Drake, R. L. (2015). Gray's Anatomy For Students, Third Edition. Philadelphia: Elsevier.

Kliegman, R. M. (2015). Nelson Textbook of Pediatrics. Philadelphia: Elsevier.

Moore, K. L. (2015). Essential clinical anatomy. Philadelphia: Wolters Kluwer Health.