Appendicitis pathophysiology: Difference between revisions
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==Gross Pathology== | ==Gross Pathology== | ||
# On the basis of experimental evidence, acute appendicitis seems to be the end result of a primary obstruction of the appendix [[lumen]] <ref> Wangensteen OH, Bowers WF. Significance of the obstructive factor in the genesis of acute appendicitis. Arch Surg 1937;34:496-526 </ref><ref> Pieper R, Kager L, Tidefelt U.Obstruction of appendix vermiformis causing acute appendicitis: An experimental study in rabbit. Acta Chir Scand 1982;148:63-72 </ref>. | # On the basis of experimental evidence, acute appendicitis seems to be the end result of a primary obstruction of the appendix [[lumen]]<ref> Wangensteen OH, Bowers WF. Significance of the obstructive factor in the genesis of acute appendicitis. Arch Surg 1937;34:496-526 </ref><ref> Pieper R, Kager L, Tidefelt U.Obstruction of appendix vermiformis causing acute appendicitis: An experimental study in rabbit. Acta Chir Scand 1982;148:63-72 </ref>. | ||
# Once this obstruction occurs, the appendix subsequently becomes filled with mucus and distends, increasing intraluminal and intramural pressures. | # Once this obstruction occurs, the appendix subsequently becomes filled with mucus and distends, increasing intraluminal and intramural pressures. | ||
# The increase in pressure leads to thrombosis and occlusion of the small vessels, and stasis of lymphatic flow. | # The increase in pressure leads to [[thrombosis]] and [[occlusion]] of the small vessels, and the stasis of lymphatic flow. | ||
# As these clots and blockages progress, the appendix becomes [[ischemic]] and then [[necrotic]]. | # As these clots and blockages progress, the appendix becomes [[ischemic]] and then [[necrotic]]. | ||
# Rarely, spontaneous recovery can occur at this point. As bacteria begin to leak out through the dying walls, pus forms within and around the appendix ([[suppuration]]). | # Rarely, spontaneous recovery can occur at this point. As bacteria begin to leak out through the dying walls, pus forms within and around the appendix ([[suppuration]]). | ||
Revision as of 14:35, 13 August 2012
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Appendicitis Microchapters |
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Appendicitis On the Web |
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American Roentgen Ray Society Images of Appendicitis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Associated Conditions
Associated conditions of Appendicitis include:
- Intestinal obstruction
- Inflammatory bowel disease
- Pelvic inflammatory disease and other gynecological disorders
- Intestinal adhesions
- Constipation
Gross Pathology
- On the basis of experimental evidence, acute appendicitis seems to be the end result of a primary obstruction of the appendix lumen[1][2].
- Once this obstruction occurs, the appendix subsequently becomes filled with mucus and distends, increasing intraluminal and intramural pressures.
- The increase in pressure leads to thrombosis and occlusion of the small vessels, and the stasis of lymphatic flow.
- As these clots and blockages progress, the appendix becomes ischemic and then necrotic.
- Rarely, spontaneous recovery can occur at this point. As bacteria begin to leak out through the dying walls, pus forms within and around the appendix (suppuration).
- The end result of this cascade is appendiceal rupture causing peritonitis, which may lead to septicemia and eventually death.