PAI PUBLIC SCHOOL

[CBSE], PUNE.
BIOLOGY PROJECT.

APPENDICITIS DISEASE

SESSION: - 2023-2024
CLASS: - XII
ROLL NO: -
NAME: -NABIL AHMED SIDDIQUI.
 COMPLETION CERTIFICATE
This is to certify that NABIL AHMED SIDDIQUI of class XII and
Roll No during the year 2023-2024 has successfully completed
his project of biology on the topic “APPENDICITIS DISEASE”
under the guidance of his 1teacher MS. ROSHANI MANIYAR.

MS. ROSHANI MANIYAR Mrs. SALTANAT PATEL

(Biology teacher) (Principal)

External Examiner Signature

 ACKNOWLEDGEMENT

I would like to express my gra tude to my biology teacher

MS. ROSHANI MANIYAR, for her vital support, guidance
and encouragement without which this project would not
have come forth. I would also like to express my gra tude
to my parents for their support during the making of this
project.
 INDEX

 Introduc on

 APPENDICITIS DISEASE

 Causes of APPENDICITIS DISEASE

 Signs and Symptoms

 Management and Treatment

 Case Studies

 FAQs

 Bibliography
 INTRODUCTION

The appendix or vermiform appendix is a muscular structure attached

to the large intestine in the human body. It is a narrow tube resembling
a worm and is named after the Latin word "vermiform" which means
‘worm-shaped’. The appendix extends from the lower end of the
cecum, a pouch-like structure in the large intestine.

The diameter of the appendix usually ranges from 7 to 8 mm and its

length ranges between 2 and 20 cm, with an average length of 9 cm.
The appendix is usually located at the lower right side of the abdomen.
In people with a rare condition called situs inversus, it can be found at
the lower left quadrant of the abdomen. The appendix is made of inner
mucosa layer just like the rest of the digestive tract and is also known
as the vermix or the cecal appendix.

=>Function in Humans
The function of the vermiform appendix in the human body is not fully
established yet. Scientists believe that it is a vestigial remnant, that is,
it was once useful to humans in the digestion of food, but as we have
evolved, it has lost its function and become redundant. Some research
studies show that the appendix is rich in lymphoid cells, which help the
body fight infections, and hence it could have a role in the body’s
immune functions.

REMEMBER-The human vermiform appendix is not considered as a

vital organ with a significant func on. The use of the appendix in the
human body is s ll a subject of debate among medical researchers and
scien sts. While some theories suggest that it is an evolu onary
remnant of a cecum that was once large and had vital diges ve
func ons, which don’t work the same way anymore, others hint that
the appendix stores good bacteria which can fight off infec ons.

Although some scientists believe that the human appendix has useful
functions in the body, they still recommend the removal of the
diseased appendix, as appendicitis or appendix cancer when left
untreated, can be fatal and also because the removal of the appendix is
not seen to cause any ill effects in the human body.
 APPENDICITIS DISEASE
The inflammation of the appendix is called appendicitis. It is caused by
the blockage of the appendix and is very painful and potentially fatal.
Appendicitis is the top most cause of acute abdominal
pain necessitating surgery in the United States, affecting more than 5%
of the population at some point of time.

Indigestible food passes from the small intestine to the large intestine
and into the appendix. The muscular walls of the appendix contract
and expel this food. When there is a blockage at the point where the
appendix and large intestine meet, it can cause the inflammation of the
appendix. This can lead to severe abdominal pain, nausea, fever and
vomiting. Symptoms of appendicitis can vary in different people. If left
untreated, a clogged appendix can rupture and release harmful
bacteria into the abdomen eventually causing peritonitis.

Mild appendicitis can be treated using antibiotics. Severe cases are

usually treated by surgically removing the appendix. This procedure is
called appendectomy and can be performed either by laparotomy in
which a single incision is made in the right lower portion of the
abdomen to remove the appendix or laparoscopic surgery which is
carried out by making many small incisions through which special tools
are inserted to remove the appendix.

Doctors often remove a healthy appendix while performing other

abdominal surgeries like a hysterectomy. This is to avoid appendicitis in
the future, as the appendix is prone to bacterial infections.

Appendicitis is a complex condition influenced by genetic,

environmental, and lifestyle factors.
 CAUSES OF APPENDICITIS DISEASE

Appendicitis happens when the inside of your appendix is blocked.

Appendicitis may be caused by various infections such as virus,
bacteria, or parasites, in your digestive tract. Or it may happen when
the tube that joins your large intestine and appendix is blocked or
trapped by stool. Sometimes tumors can cause appendicitis.

The appendix then becomes sore and swollen. The blood supply to the
appendix stops as the swelling and soreness get worse. Without
enough blood flow, the appendix starts to die. The appendix can burst
or develop holes or tears in its walls, which allow stool, mucus, and
infection to leak through and get inside the belly. The result can be
peritonitis, a serious infection.
 SIGNS AND SYMPTOMS
The symptoms of appendicitis can vary. It can be hard to detect
appendicitis in young children, older people, and women of
childbearing age.

The first symptom is often pain around the belly button or mid upper
abdomen. Pain may be minor at first, but becomes more sharp and
severe. You may also have a loss of appetite, nausea, vomiting, and a
low-grade fever.

The pain tends to move into the right lower part of your belly. The pain
tends to focus at a spot directly above the appendix called McBurney
point. This most often occurs 12 to 24 hours after the illness starts.
Your pain may be worse when you walk, cough, or make sudden
movements. Later symptoms include:

 Chills and shaking

 Hard stools

 Diarrhea

 Fever

 Nausea and vomiting

You may never have given much thought to your appendix, the little
pouch that's attached to the top of your large intestine. And you
wouldn't have much reason to think about it, because it doesn't seem
to do anything. But if your appendix were to become swollen and
inflamed, it would probably move to the front of your mind. The pain
of appendicitis can make you quickly, and unpleasantly, familiar with
this organ. You can get appendicitis if your appendix becomes blocked.
That blockage could be from feces, a foreign object, or, in rare cases, a
tumor. When your appendix is blocked up, bacteria that normally live
inside it start multiplying like crazy, and cause an infection. If you've
got appendicitis, you'll usually have pain that's centered around the
area of your belly button. At first the pain may be minor, but it can get
very severe and will usually drift downward to the bottom right part of
your abdomen. You may also have nausea, vomiting, Diarrhea or
constipation, and a low fever. Your pain may let up for a time. This
relief can be misleading, though. Just when you think you're getting
better, your appendix may have actually burst. If that's the case, the
pain will get start to get more and more intense. To diagnose
appendicitis, your doctor will ask about your symptoms and press on
your abdomen, which will feel very tender. You may need imaging
tests, such as a CT scan or ultrasound of your abdomen, so the doctor
can see if the problem is with your appendix. If you have appendicitis,
the number one way to treat it is with surgery to remove your
appendix. In fact, appendicitis is the number one cause of emergency
abdominal surgery in the U.S. You may be treated for an infection first,
before your surgery. It's important to treat the appendicitis quickly
because you can develop a collection of pus called an abscess in your
abdomen once your appendix bursts. Don't worry about going through
life without an appendix. People live healthy lives without it. Once
you've had your appendix taken out, you should feel a lot better. If
your appendix has ruptured, it may take you longer to recover. You
may also develop an abscess or other complications. That's why you
don't want to wait until your appendix has already burst to get treated.
Call your doctor for any severe pain in your abdomen, especially if you
also have a fever, vomiting, constipation, dizziness, or other severe
symptoms.
 MANAGEMENT AND TREATMENT
Most of the time, a surgeon will remove your appendix as soon as you
are diagnosed.
If a CT scan shows that you have an abscess, you may be treated with
antibiotics first. You will have your appendix removed after the
infection and swelling have gone away.
The tests used to diagnose appendicitis are not perfect. As a result, the
operation may show that your appendix is normal. In that case, the
surgeon will remove your appendix and explore the rest of your
abdomen for other causes of your pain.

Appendectomy, the removal of the small pouch attached to the

beginning of your large intestine when you have an acute bout of
appendicitis is one of the most common emergency abdominal
surgeries. The appendix is a small, finger-shaped organ that comes out
of the first part of the large intestine. It needs to be removed when it
becomes swollen or infected. If the appendix is not removed, it can
leak bacteria and infect your entire belly, which can be very life
threatening. So, what are the signs that you have appendicitis? Well,
this condition can be fairly hard to diagnose, especially in children,
older people, and women of childbearing age. Usually, the first
symptom is pain around your belly button. The pain might be mild at
first, but then it gets sharp and severe before not too long. The pain
may then move into your right lower abdomen. You may also have
diarrhea, fever, nausea, and a reduced appetite. Sometimes, people
think that they might be having food poisoning. Your doctor will make
a diagnosis based on your symptoms. You may also have blood tests
and a CT scan or ultrasound. Once it's clear that you have appendicitis,
your doctor will probably schedule you for emergency surgery. In
surgery, you will receive anesthesia and be asleep and pain free. The
doctor will make a small cut in the lower right side of your belly and
remove your appendix. If the surgeon uses the laparoscopic technique,
you will have several small cuts in your abdomen for the surgical
instruments. If your appendix broke open, or a pocket of infection has
formed, your doctor will wash out your belly during the surgery. A
small tube may remain to help drain out fluids or pus. Once you've had
an appendectomy, you will probably recover pretty quickly. It feels
good to get a bad appendix out. Most patients leave the hospital 1 to 2
days after surgery. The good news is that you'll be able to go back to all
those normal activities within 2 to 4 weeks.
 CASE STUDIES.
A 43-year-old woman presented with a 3-day history of peri-umbilical
pain which had localised to the right iliac fossa by the time she
attended hospital. She described the pain as sharp in nature, constant
and was aggravated by movement. She had no bowel or urinary
symptoms and no previous abdominal problems. Upon admission, she
had a low-grade pyrexia. Examination findings revealed a soft abdomen
with tenderness and guarding in the right iliac fossa. There appeared to
be a fullness over the tender area, but there was no rebound
tenderness and she was Rovsing's sign negative. Urinalysis revealed no
abnormality and routine blood tests showed a mild leukocytosis of 12.5
× 109/l (range, 4.0–11.0 × 109/l) with a neutrophilia of 10.5 × 109/l
(range. 2.0–7.5 × 109/l). Chest and abdominal radiographs were
unremarkable.

The following morning, she showed a slight improvement with

conservative management and a period of observation, although she
still had a low-grade pyrexia and was tender on palpation in the right
iliac fossa. This was initially thought most likely to be an atypical
presentation of appendicitis or an appendicular mass. An ultrasound
scan of the abdomen and pelvis demonstrated a minimal amount of
fluid in the pelvis. Following a further day of observation, a CT scan was
performed which proved to be equivocal, although the possibility of
appendicitis and omental torsion was raised (Fig. 1). Further blood
testing showed an improvement in the neutrophil count, but she
remained tender in the right iliac fossa. As there was no diagnosis
reached by day 4, and with no definitive improvement, the decision
was made to perform a laparoscopy with a view to undertake an
appendicectomy. At laparoscopy, the appendix appeared normal, along
with all other major abdominal organs. However, there was a large 8
cm by 7 cm omental mass positioned in the right lower quadrant and a
definite point of torsion. Histology confirmed this as a segment of
ischaemia omentum. An omentectomy and appendicectomy was
performed. Histological analysis proved the surgical specimen to be a
segment of ischaemic omentum (Fig. 2A), with a normal appendix (Fig.
2B). She had an uneventful postoperative recovery and 2 months
further on remains well.
Conclusions: -
Although there are cases of omental torsion in the literature, they are
predominantly in a pediatric popula on. The authors would like to
highlight the poten al pi alls in diagnosing acute abdominal
condi ons, in par cular those which mimic appendici s, and the
resistance to using imaging tools to exclude serious surgical pathology
when the diagnosis is uncertain. Ul mately, in many cases, it is only by
clinical suspicion and appropriate surgical interven on that a confident
diagnosis can be made.
 FAQS
1. What is the treatment for appendicitis?
A: Appendectomy via open laparotomy or laparoscopy is the standard
treatment for acute appendicitis. However, intravenous antibiotics may
be considered as a first-line therapy for select patients. Pain control
with nonsteroidal anti-inflammatory drugs, and acetaminophen should
be a priority and does not result in delayed or unnecessary
intervention.

2. When does appendicitis require open abdominal surgery?

A: If your appendix has ruptured and infection has spread beyond the
appendix, or if you have an abscess, you may need an open
appendectomy, which allows your surgeon to clean the abdominal
cavity.

3. What happens when the appendix is removed?

A: In the days following an appendectomy, you may feel moderate pain
in the areas where incisions were made. Any pain or discomfort should
improve within a few days. Your doctor may prescribe medication to
relieve the pain. They might also prescribe antibiotics to prevent an
infection after surgery.

4. Can you delay appendix surgery?

A: Acute appendicitis is one of the most common acute conditions
requiring an emergency operation. Immediate appendectomy is
considered the gold-standard treatment for acute appendicitis. It is
widely believed that delays in diagnosis and treatment significantly
contribute to increased incidences of perforated appendicitis, which
result in increased patient morbidity.

5. What are the side effects of an appendectomy?

A: Some possible complications of an appendectomy include:

 Bleeding
 Wound infection
 Infection and redness and swelling (inflammation) of the belly that
can occur if the appendix bursts during surgery (peritonitis)
 Blocked bowels
 Injury to nearby organs

You may have other risks that are unique to you. Be sure to discuss any
concerns with your healthcare provider before surgery.

6. Can an appendix heal itself?

A: Since the late 1800s, doctors have turned to surgery to treat
appendicitis. Some cases of mild appendicitis get better with
antibiotics alone but your doctor will watch you closely to determine if
you need surgery.
 BIBLIOGRAPHY
 NCERT BIOLOGY CLASS 11/12
 h ps://www.news-medical.net/
 h ps://www.mayoclinic.org/
 www.google.com