Chapter 44: Appendix- Common IntraOp questions

Question 1

What are the layers of the abdominal wall during a McBurney incision?

Answer 1

1. Skin
2. Subcutaneous fat
3. Scarpa’s fascia
4. External oblique
5. Internal oblique
6. Transversus muscle
7. Transversalis fascia
8. Preperitoneal fat
9. Peritoneum

Question 2

If you find Crohn’s disease in the terminal ileum, will you removethe appendix?

Answer 2

Yes, if the cecal/appendiceal base is not involved

Question 3

If the appendix is normal what do you inspect intraoperatively?

Answer 3

1. Terminal ileum:
   
   • Meckel’s diverticulum
   • Crohn’s disease
   • intussusception
2. Gynecologic:
   
   • Cysts
   • torsion
3. Groin:
   
   • hernia
   • rectus sheath hematoma
   • adenopathy (adenitis)