Chapter 51 – The Appendix

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1、CHAPTER51THEAPPENDIXJohnMaaandKimberlyS.Kirkwoodearlysurgicaltreatmentofthedisease.RichardHallreportedembryologyandanatomythefirstsurvivalofapatientafterremovalofaperforatedappendicitisappendix,whichfocusedattentiononthesurgicaltreatmentneoplasmsofacuteappendicitis.In1889,ChesterMcBu

2、rneydescribedcharacteristicmigratorypainandlocalizationofthepainalonganobliquelinefromtheanteriorsuperioriliacspinetotheApproximately8%ofthoseinWesterncountrieshaveappendi-umbilicus.McBurneydescribedarightlowerquadrantcitisatsometimeduringtheirlife,withapeakincidencemuscle-splittingi

3、ncisionforremovaloftheappendixin1894.1between10and30yearsofage.AcuteappendicitisisthemostThemortalityratefromappendicitisimprovedwiththewide-commongeneralsurgicalemergency,andearlysurgicalinterven-spreaduseofbroad-spectrumantibioticsinthe1940s.tionimprovesoutcomes.Thediagnosisofappen

4、dicitiscanbeAdvanceshaveincludedimprovedpreoperativediagnosticelusive,andahighindexofsuspicionisimportantinpreventingstudies,interventionalradiologicprocedurestodrainestab-seriouscomplicationsfromthisdisease.Worldwide,perforatedlishedperiappendicealabscesses,andtheuseoflaparoscopytoa

5、ppendicitisistheleadinggeneralsurgicalcauseofdeath.confirmthediagnosisandexcludeothercausesofabdominalpain.LaparoscopicappendectomywasfirstreportedbytheEMBRYOLOGYANDANATOMYgynecologistKurtSemmin1982buthasonlygainedwide-Theappendix,ileum,andascendingcolonareallderivedfromspreadaccepta

6、nceduringthepastdecade.Otherminimallythemidgut.Theappendixfirstappearsattheeighthweekofinvasiveapproachestoappendectomyhavebeenreported,3gestationasanoutpouchingofthececumandgraduallyrotatesincludingtransvaginalandsingle-incisionlaparoscopic4toamoremediallocationasthegutrotatesandthe

7、cecumsurgery(SILS);however,thesehavenotasyetbeenwidelybecomesfixedintherightlowerquadrant.adopted.Theappendicealartery,abranchoftheileocolicartery,suppliestheappendix.HistologicexaminationoftheappendixPathophysiologyindicatesthatgobletcells,whichproducemucus,arescatteredObstructionof

8、thelumenisbe