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shaped opening (2-3% of patients). The appendix has a retroperitoneal location in 65% of patients and may descend into the iliac fossa in 31%. In fact, many individuals may have an appendix located in the retroperitoneal space; in the pelvis; or behind the terminal ileum, cecum, ascending colon, or liver. Thus, the course of the appendix, the position of its tip, and the difference in appendiceal position considerably changes clinical findings, accounting for the nonspecific signs and symptoms of appendicitis.
Physiology of Appendix
The lumen of the appendix communicates with the cecum 3cm (about 1 inch) before the ileoccal valve, thus making it an accessory organ of the digestive system. Its functions are not certain, but some biologists believe that the appendix serves as a sort of
“
breeding
ground”
for some of the nonpathogenic intestinal bacteria thought to aid in the digestion or absorption of nutrients. Follicles of lymphoid tissue appear in the wall of the appendix shortly a few birth, become more prominent during the first 10 years of life and then progressively disappear. The defense or immune system function of lymphatic tissue present in the appendix of young children is not fully understood