Where is the appendix?

Where is the appendix located? The appendix is ​​a body tissue that everyone has. Like wisdom teeth, the appendix is ​​a relic of human evolution. In primitive times, the appendix was an important place for humans to digest crude fiber. However, as human food became more and more refined, it gradually degenerated into an unimportant organ. The range of movement and position of the appendix varies greatly from person to person. Affected by the mesentery and other factors, the appendix can extend to any direction in the abdominal cavity. So where exactly is it in the human body?

Location of the appendix:

The appendix is ​​usually located in the right lower abdomen, at the end of the cecum. There are also a few cases of ectopic appendix, such as the left appendix, or a high appendix, such as the subhepatic appendix, and some are retroperitoneal appendix, but these are extremely rare. Because the lumen of the appendix is ​​relatively narrow, and the blood vessels of the appendix are terminal blood vessels, it is sometimes easy to get appendicitis.

What are the risks of appendectomy?

1: First of all, surgery has risks, so don’t be superstitious about so-called “minor surgery”. Friends who have a strong thirst for knowledge can take a look at the 1989 edition of "Practical Surgery". The book clearly states at the beginning of the chapter on appendectomy that "do not treat appendectomy as a minor operation, it will cause many problems."

2: Reasons related to postoperative complications and medical level. Postoperative complications include intestinal adhesion, intestinal obstruction, nerve damage, wound infection, appendicitis, scar hyperplasia, etc. Most of these complications are related to the doctor's level and sense of responsibility. Let me make one thing clear: the pain caused by scar hyperplasia is far greater than other pains of surgery. Therefore, people with scar-prone constitution must be cautious about surgery.

3: Description of surgical complications and surgical errors.

1. Intestinal adhesion: Unnecessary adhesion between the intestinal mucosa, peritoneum and abdominal wall can cause symptoms such as abdominal pain and constipation.

2. Intestinal obstruction: caused by intestinal adhesion, it is severe constipation and severe cases require surgery.

3. Nerve damage: No need for further explanation, it is an inevitable consequence of surgery.

4. Wound infection: Appendicitis itself is an infectious disease, containing a large number of bacteria such as Escherichia coli and Enterococcus. The surgical incision is a Class II or Class III incision, which is a suspected contaminated wound or a contaminated wound (depending on the degree of suppuration and whether there is perforation). In severe cases, the wound may not heal for a long time and may even form sinus tracts.

5. Appendicitis: The appendix is ​​not removed completely, leaving a stump of more than 1 cm, which continues to become inflamed and requires a second operation.

6. Scar hyperplasia: This is a sequelae exclusive to those with scar-prone constitution. Those with normal constitution can recover in 3 months, but those with scar-prone constitution may be affected for half a year to several years. The pain caused by scar hyperplasia can affect the whole body. Long-term pain can lead to other diseases such as depression, neurological disorders, and cause secondary sequelae. Mood swings, weather changes, and spicy foods can all cause scar pain.

How is appendicitis diagnosed?

1. When the patient with acute appendicitis lies on his back, press the left lower abdomen with his right hand, and then squeeze the proximal colon with his left hand. The gas in the colon can be transmitted to the cecum and appendix, causing pain in the right lower abdomen, which is a positive result.

2. Lie on your left side and extend your right thigh backward. If this causes right lower abdominal pain, it is a positive result. This indicates that the appendix is ​​located in front of the psoas major muscle, behind the cecum or behind the peritoneum.

3. The patient lies in supine position, flexes the right hip and right thigh, and then passively rotates them inward. If this causes right lower abdominal pain, the test is positive. This indicates that the appendix is ​​close to the obturator internus muscle.

4. For patients with a history of acute appendicitis and subsequent recurrent (intermittent) appendicitis with obvious symptoms and signs, diagnosis is not difficult; for chronic (obstructive) appendicitis without a history of acute appendicitis, barium enema examination is more helpful.