Professional Documents
Culture Documents
PATHOPHYSIOLOGY
Episodes of
constipation
RLQ
Abdominal pain,
Vomiting
Inflammation of appendix
Rupture of appendix
Hyperthermia
WBC
Peristalsis
Secondary Peritonitis
Abdominal
distention
Hypoactive
bowel sounds
Immune response
Release of chemical
mediators
(macrophages, fibrin, blood cells)
Adhesions
Intestinal obstruction
Ischemia of the bowel wall
Exploratory
Lapatoromy
49 | Pathophysiology
Hypoalbuminemia
Delayed wound
healing
Disruption of
anastamosis
Anastamosis leak
yellowish abdominal
secretion
Tertiary Peritonitis
Bipedal Edema
Poor skin turgor
Septic Shock
Cardiogenic
shock
Hypovolemic shock
Vasodilation
Cardiac
contractility
Pulse rate
Delayed capillary
refill
Decrease venous
return
Low cardiac output
Hypotension
Blood pressure of
70/50 mmhg
Microcirculatory
changes
Poor perfusion of vital
organ
Inability to
utilize/remove
metabolic waste
Decrease oxygen
delivery
Oxygen
saturation
Subcellular
and cellular
injury
Release of toxic products
Down regulation of oxygen metabolism
Failure of energy production
acidosis
Major organ
dysfunction
acidosis
Urine production
Urine concentration
Constipation
Septicemia
DEATH
50 | Pathophysiology
Interpretation:
The appendix is a small, finger-like appendage attached to the cecum just below
the ileocecal valve. Because it empties into the colon inefficiently and its lumen is small,
it is prone to becoming obstructed and vulnerable to infection.
The factors that increases the risk of the patient of having appendicitis is that he is
a male having episodes of constipation, and consuming a low fiber diet. These factors
might contribute to the occlusion of foreign body to the appendix. Once occlusion
happens, an increase in intra luminal pressure and vasocongestion occurs. This decreases
the blood supply as well as oxygen supply in the appendix which will disrupt the cellular
membrane and functions. Due to the disruption of the cell membrane of appendix,
inflammation of the appendix occurs as manifested by right lower quadrant abdominal
pain and vomiting.
Once rupture, the appendix releases fecal materials in the abdominal cavity,
which causes a decrease in peristaltic movement and secondary peritonitis.
The release of fecal materials in the abdominal cavity causes a decrease in peristaltic
movement due to increase gas and fluid content as evidence by abdominal distention and
hypoactive bowel sounds.
Secondary Peritonitis occurs as an inflammatory response of the peritoneum
secondary to rupture of underlying organs. Because peritoneum is particularly well
adapted for producing an inflammatory response, hyperthermia, and increase white blood
cell count is evident. Release of chemical mediators such as macrophages, fibrin, and
blood cell adheres to structures (adhesions) to seal of the appendix and localized the
51 | Pathophysiology
52 | Pathophysiology