Schematic Pathophysiology of Acute Appendicitis

Predisposing Contributing Factors:

Factors: • Diet; Low-fiber, high in Carbohydrate
• Gender (more
common in • Swollen lymph glands (on the wall of the appendix)
males)
• Age (10 to 30 • Fecal mass
y/o)
• Ingestion of foreign bodies (may be in form of small swallowed
beads, grain of fruits, cereals, fish bone or sand)
Precipitating Factor
Occlusion of Appendix by Fecalith (Fecal Stone)

Appendiceal mucus secretions continue

Accumulated intraluminal fluid

Congestion

Increased ILP in the appendix

↓ venous return

Decreased blood supply in the appendix

Decreased Oxygen supply in the appendix decreased WBC and other fighters of infection

Mucosal ischemia Luminal bacterial overgrowth

Normal bacteria found in the gut invade the appendix

Disruption of Cell Membrane of Appendix

Start of Inflammatory Process

Release of Chemical Mediators Stimulation of Vagus nerve Neutrophils to area

Histamine, Prostaglandin,
Leukotrienes, Bradykinin Activation of the Pus Formation
vomiting center in Suppression of (phagocytized bacteria
Swelling of Appendix medulla Sympathetic and dead cells)
Prostaglandin, Bradykinin GI Function
Pain in the RLQ of Abdomen
Risk for Infection
Acute Pain Nausea & Vomiting Anorexia (if appendix ruptures)
Interleukin-1

Increased WBC Risk for Deficient Risk for Imbalanced Nutrition

Fluid Volume less than body requirements
 Inflammation of Appendix (Appendicitis)

Appendectomy

Tissue Trauma

Open Wound
Cellular injury Stimulation of nociceptors on the
Dermis
Impaired Tissue Risk for Inflammatory
Integrity Infection Response Send Impulse to CNS

Release of Prostaglandin/ Pain on Surgical

Bradykinin Site