Why does appendicitis perforation lead to bowel stenosis

[sanj238]

cant seem to figure this one out.

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[NeuroLAX]

Found this: http://onlinelibrary.wiley.com/doi/10.1111/j.1443-1661.1989.tb00037.x/abstract

"Described is a 49-year-old Japanese male who developed an ascending colon stenosis secondary to perforated appendicitis. The patient was examined at our hospital because of an abdominal pain and the presence of a firm mass in the right flank. A barium enema and colonoscopic examination revealed an ascending colon stenosis with multiple nodular elevations. On laparotomy, an inflammatory mass, originating from a ruptured appendix, was found adhered to the cecum and the ascending colon. Thus, a right hemicolectomy was performed. Microscopic examination revealed a periappendiceal abscess with marked submucosal fibrosis and lymphoid hyperplasia of the ascending colon and cecum.

Large intestinal stenosis is a rare complication of appendicitis, and there have been only a few reported cases involving the ascending and sigmoid colon, and the rectum. In these cases, however, the polypoid lesions as seen in our case have never been described. In reviewing the literature, we found only two other cases in which a coarse or a polypoid lesion, similar to our case, was noted in the cecum, though the mucosal change was localized and luminal stenosis did not occur. Thus, when a patient with an ascending colon stenosis is encountered, a possibility of periappendiceal abscess must be kept in mind."

 

[sanj238]

Found this: http://onlinelibrary.wiley.com/doi/10.1111/j.1443-1661.1989.tb00037.x/abstract

"Described is a 49-year-old Japanese male who developed an ascending colon stenosis secondary to perforated appendicitis. The patient was examined at our hospital because of an abdominal pain and the presence of a firm mass in the right flank. A barium enema and colonoscopic examination revealed an ascending colon stenosis with multiple nodular elevations. On laparotomy, an inflammatory mass, originating from a ruptured appendix, was found adhered to the cecum and the ascending colon. Thus, a right hemicolectomy was performed. Microscopic examination revealed a periappendiceal abscess with marked submucosal fibrosis and lymphoid hyperplasia of the ascending colon and cecum.
Large intestinal stenosis is a rare complication of appendicitis, and there have been only a few reported cases involving the ascending and sigmoid colon, and the rectum. In these cases, however, the polypoid lesions as seen in our case have never been described. In reviewing the literature, we found only two other cases in which a coarse or a polypoid lesion, similar to our case, was noted in the cecum, though the mucosal change was localized and luminal stenosis did not occur. Thus, when a patient with an ascending colon stenosis is encountered, a possibility of periappendiceal abscess must be kept in mind."

This is stupid why the hell is such a low yield point made in FA- i remember skipping it for the comlex and justknowing. but for USMLE I'm wary. Seriously- why is this even in FA.

 

[NeuroLAX]

What page is that on? I don't remember seeing that written in 2014.

 

[Transposony]

This is very very rare & low yield even for Surgical boards.

 

[sanj238]

What page is that on? I don't remember seeing that written in 2014.

Oops. It was diverticulitis. Still confused.

Really sorry.

 

[sanj238]

What page is that on? I don't remember seeing that written in 2014.

Nvm. Causes narrowing due to inflammation from diverticulitis

 

[ChessMaster3000]

Nvm. Causes narrowing due to inflammation from diverticulitis

a high(er) yield point is that diverticular inflammation can erode into the bladder and was pneumaturia

 

[NeuroLAX]

a high(er) yield point is that diverticular inflammation can erode into the bladder and was pneumaturia

Ah yes, the colovesical fistula. How lovely.

 

[ChessMaster3000]

Ah yes, the colovesical fistula. How lovely.

all day every day man