Acute appendicitis is the most common reason for emergency abdominal surgery worldwide. While complicated appendicitis is associated with increased morbidity and mortality, the process leading to complicated disease remains unclear. The mesentery plays a key role in the immunologic and inflammatory processes of gastrointestinal disorders. In this study, we tried to reveal the role of the mesoappendix in subjects with acute appendicitis and its relationship to inflammatory severity in complicated appendicitis.

101 patients with acute appendicitis were retrospectively re-examined. The patients’ mean age, gender, and appendicitis status were recorded. Appendicolith status, neutrophilic inflammation, and grade of the lumen and the mesoappendix were analysed.

There was no statistically significant relationship between fecalith and complicated appendicitis (p > 0.05). There was a statistically significant relation between the degree of inflammation in the mesoappendix and complicated appendicitis (p < 0.001). Furthermore, there was a statistically significant relation between the severity of neutrophilic inflammation in the lumen and complicated appendicitis (p < 0.01).

The severity of neutrophilic inflammation in the mesentery may predict complicated appendicitis, while the presence of fecalith does not. These results show the pathogenetic importance of the mesoappendix in the development of complicated appendicitis.