Suppurative Appendicitis at 20x Magnification
Suppurative appendicitis has traditionally been considered a later stage of appendicitis, in which bacteria and inflammatory fluids accumulated in the lumen of the appendix enter the wall of structure and subsequently cause intense pain when the inflamed membrane rubs against the parietal peritoneum lining the abdominal cavity. Accordingly, for many years incidence of suppurative appendicitis was utilized as a measure of medical care since, according to this view, delays in diagnosis or treatment increase the likelihood of suppuration. Recent research, however, indicates that acute appendicitis and suppurative appendicitis may develop through discrete processes. For instance, one intriguing study found that the incidence of acute appendicitis is greatest among teenagers, but that incidence of suppurative appendicitis does not vary by age. Also, according to some researchers, acute appendicitis is more frequently linked to mucosal ulceration than suppurative appendicitis, which is more often caused by obstruction of the appendix. It has even been suggested that small epidemics of acute appendicitis could be associated with a viral agent, though more studies must be carried out on the subject to more fully understand such occurrences.