Pathophysiology of acute appendicitis.

Abstract

Background: Acute appendicitis, the most common abdominal emergency that requires surgical treatment, shows a lifetime risk of 7%. Its overall incidence is approximately 11 cases per 10,000 individuals per year, and may occur at any age, although it is relatively rare at the extremes of age. Method: This article presents a recent-year-review of acute appendicitis, based on a study of references found in the PUBMED, using the key word of “pathophysiology of acute appendicitis” as research limitation. Results: The function of the appendix is not clearly understood, although the presence of lymphatic tissue on it suggests a role in the immune system. The primary pathogenic event in most of patients with acute appendicitis is believed to be due to luminal obstruction. Although being logical and likely to be true, this theory has not been proven. There is strong epidemiologic evidence supporting the proposition that perforated and non-perforated appendicitis are separate entities with a different pathogenesis. Recently, with the advent of neurogastroenterology, the concept of neuroimmune appendicitis has evolved. Considering that neurogenic disease may not include inflammatory signs, the name “neurogenic appendicopathy” seems to be a more appropriate term for appendices of morphological normal aspect in patients with clinical symptoms of acute appendicitis. Conclusion: As it can be perceived, based on the large number of studies related to acute appendicitis, it is not yet established the pathophysiology of this disease More research is in need to understand this still mysterious disease.