Acute Appendicitis (Operative Findings)

Operative findings in a schoolchild with 'surgical abdomen'. View from the right side of the patient on the right lower abdomen: The hand pulls the cecum upwards; the appendix starts at the tenia libera and runs in the direction of the retractor, disappears behind the prolapsing intestinal loop and continues vertically to the right side of the patient. Notice the distinctly visible vessels of the appendix and the yellowish, adherent coats at the level of the swab. The diagnosis is acute appendicitis with a fibrinous-purulent reaction of the serosa without visible diffuse peritonitis or cellulitis of the appendical wall. The appendix lies retrocecally; the mobile cecum, mesentery, and base of the appendix with some adhesions support a chronic recurrent retrocecal appendicitis.