Gastrointestinal System Disorders Q 4

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Which of the following complications is thought to be the most common cause of appendicitis?

  

    A. A fecalith

    B. Bowel kinking

    C. Internal bowel occlusion

    D. Abdominal bowel swelling

    

    

Correct Answer: A. A fecalith

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A fecalith is a fecal calculus, or stone, that occludes the lumen of the appendix and is the most common cause of appendicitis. The cause of appendicitis is usually an obstruction of the appendiceal lumen. This can be from an appendicolith (stone of the appendix), or some other mechanical etiologies. Appendiceal tumors such as carcinoid tumors, intestinal parasites, and hypertrophied lymphatic tissue are all known causes of appendiceal obstruction and appendicitis.

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Option B: Kinking of the appendix is one of the causes of appendicitis. Appendicitis is inflammation of the vermiform appendix. This is a hollow organ located at the tip of the cecum, usually in the right lower quadrant of the abdomen.

Option C: External, not internal, occlusion of the bowel by adhesion is a cause of appendicitis. When the appendiceal lumen gets obstructed, bacteria will build up in the appendix and cause acute inflammation with perforation and abscess formation.

Option D: Bowel wall swelling is one of the causes of appendicitis. The pathophysiology of appendicitis likely stems from obstruction of the appendiceal orifice. This results in inflammation, localized ischemia, perforation, and the development of a contained abscess or frank perforation with resultant peritonitis.

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