4. What happens to the appendix once it has been obstructed?
Correct answer:
The obstructed appendix acts as a closed loop; bacteria proliferate in the lumen and invade the appendix wall, which is damaged by pressure necrosis. The vascular supply to the appendix is made up of end-arteries, which are branches of the appendicular branch of the ileocolic artery. Once these are thrombosed, gangrene is inevitable and is followed by perforation.
