Beyond acute inflammation: a review of appendicitis and infections of the appendix

Abstract

Although the appendix is the most commonly resected and examined intra-abdominal organ, the pathogenesis and aetiology of acute non-specific appendicitis (the commonest diagnosis made in the appendix) remains enigmatic. This review encompasses the pathology and diagnosis of acute non-specific appendicitis, as well as controversial issues such as the diagnosis of chronic appendicitis, the implications of granulomatous appendicitis, and the significance of a morphologically unremarkable appendectomy specimen in the clinical context of appendicitis. The pathological features, pertinent diagnostic techniques, and clinical significance of several specific bacterial, viral, fungal, and parasitic infections affecting the appendix are presented, including adenovirus, cytomegalovirus, Yersinia species, Actinomyces, Mycobacteria species, Histoplasma, Enterobius vermicularis, schistosomiasis, and Stronyloides stercoralis.