Stage of Disease 4 (Appendicitis)

abdo_5a_n.jpg: Operative findings in a 12.9-year-old girl. The assistant holds the cecum covered by veiled adhesions. The appendix which is directed toward the left side of the patient is deep-red and at the level of an alvine calculus nearly totally amputated due to necrosis. Retrocecal appendicitis as shown in this case report is often diagnosed too late or not noticed in case of episodic symptoms, for which the presented case is an example, supported by the perforated appendicitis and the described adhesions. abdo_5b_n.jpg: Operative findings in a 12.9-year-old boy. The intestinal loops near the appendix are dark-red, their wall is thickened and exhibits localized bleeding, very adherent and yellow coats ($$abdo_01??££alternate picture§§ ). It is the sequel of a localized fibrinous-purulent peritonitis, in which this type of reaction of the adhesive intestinal loops in the area of the appendix or other pelvic organs has led to a localization and encapsulation of the abscess caused by perforation. This healing process holds the danger of a postoperative obstruction due to these changes of the serosa ($$abdo_26??££alternate pictures§§ ).