Appendicitis
Appendicitis is inflammation of the appendix. The appendix is a small, thin, worm-like structure (and therefore called vermiform, or "like a worm") which is attached to the caecum, the start of the large bowel. It is a tube which is closed off at one end and is thought possibly to be a developmental remnant left over from the time when humans were ruminants and had more than one stomach. Because it is narrow and closed off it is at risk of getting blocked (by such things as lymphoid tissue, worms, food debris or shotgun pellets in game!) producing inflammation and infection.
Classically the pain is felt initially at the centre of the stomach, because this is where the nerve supply to the bowel originates. As the appendix becomes more inflamed it irritates the peritoneum which lies over it, producing pain localised to the lower right side of the abdomen. Should the appendix perforate then inflammation may spread throughout the whole of the peritoneal cavity causing peritonitis and generalised abdominal pain. In some cases the inflamed appendix may be cocooned by a fold of peritoneum formed by an apron-like structure called the omentum (this is sometimes known as the policeman of the abdomen since its function is to contain the spread of infection and inflammation). When the inflamed appendix is walled off in this manner it forms an appendix mass. The treatment of appendicitis - and an appendix mass - requires surgery.
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