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PATHOPHYSILOGY of APPENDICITIS

Predisposing factors Precipitating factors:


- Age: 10 -30 yrs old - Constipation/IBD
- Gender: male (2:1) - Diet (low fiber)
LEGEND:

+ Bold - signs & symptoms


Fecal obstruction + Underlined - medical procedure or
intervention
+ - not experienced by the patient
Occlusion of Appendix by Fecalith

Increased ILP in the appendix

Vasocongestion Pain

Hypoxia in the appendix Pyrogens

Appendix starts to be necrotic; Bacteria invade the appendix Hypothalamus (prostaglandin production)

Disruption of Cell Membrane of Appendix Fever

Start of Inflammatory Process

Mast Cells Activation of the Vomiting Inflammation of Appendix (Appendicitis)


Center in the Medulla
Appendectomy
Bradykinin Prostaglandin Histamine Leukotrienes interleukin - 1
Stimulation of vagus nerve suppression of sympathetic Tissue Trauma
vasoconstriction GI function

vasodilation increase WBC Nausea and vomiting anorexia


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18.30 x 10 /L disruption of cell Nociceptors on the dermis
increase permeability membrane

accumulation of WBC start of inflammatory send impulses to the CNS


to the interstitial compartment process
swelling of Abdomen
Phagocytosis pain, & weight loss
Septic shock: pain, swelling, heat & redness
swelling Exudates rupture of Peritonitis sepsis if NOT treated - decreased Blood Pressure DEATH
the swelled appendix (septecemia) - decreased Blood Volume

Pain Appendectomy with If treated strong antibiotic and RECOVERY


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