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  • further
  • Appendicitis occurring in this setting if further unusual. (
  • In severe cases a prominent neutrophilic exudate  serosal fibrinopurulent reaction  focal abscesses may form within the wall (acute suppurative appendicitis)  further appendiceal compromise areas of hemorrhagic ulceration and gangrenous necrosis that extends to the serosa (acute gangrenous appendicitis), which is often followed by rupture and suppurative peritonitis. (