Appendicitis pathophysiology

https://https://www.youtube.com/watch?v=r9amif1DQMc|350}}

Appendicitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Appendicitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Diagnostic Scoring

X Ray

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Appendicitis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Appendicitis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Appendicitis

CDC on Appendicitis

Appendicitis in the news

Blogs on Appendicitis

Directions to Hospitals Treating Appendicitis

Risk calculators and risk factors for Appendicitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Farwa Haideri [2]

## Overview

[edit | edit source]

Appendicitis is caused by the obstruction of the tubular space inside the appendix. This initial problem is compounded into a cascade of events that lead to the inflammation of the appendix, the obstruction of the blood vessels supplying it, and infection. Once these blood vessels are obstructed, appendiceal tissue starts to die and leak out its cellular components.

## Pathophysiology

[edit | edit source]

### Pathogenesis

[edit | edit source]

* On the basis of experimental evidence, acute appendicitis is the end result of a primary obstruction of the appendiceal lumen.[1]
* Appendiceal luminar obstructions are a common inciting event leading to inflammation.[2]
* Appendiceal obstructions can be caused by:[2]
* Fecaliths
* Lymphoid Hyperplasia
* Benign or malignant tumors
* Infectious processes
* Obstructions can lead to an increase in endoluminar and intramural pressure, which can result in an occlusion of the venules in the appendiceal wall.
* The appendix can fill with mucus and distends.
* The increase in pressure leads to thrombosis and occlusion of the small vessels, and stasis of lymphatic flow.

### Associated Conditions

[edit | edit source]

Associated conditions of appendicitis include:[2]

* Intestinal obstruction
* Inflammatory bowel disease
* Pelvic inflammatory disease and other gynecological disorders
* Intestinal adhesions
* Constipation

### Gross Pathology

[edit | edit source]

* Inflammation of the appendiceal wall can result in perforation and development of a contained abscess or generalized peritonitis.
* The wall of the appendix can become ischemic as vascular and lymphatic occlusion progress.[2]

Inflammed appendix
source:Case courtesy of Dr Andrew Dixon, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/9644">rID: 9644</a>

## References

[edit | edit source]

1. ↑ Wangensteen OH, Bowers WF. Significance of the obstructive factor in the genesis of acute appendicitis. Arch Surg 1937;34:496-526
2. ↑ 2.0 2.1 2.2 2.3 Yelon, Jay A. & Luchette, Fred A. (2014), Geriatric Trauma and Critical Care (1st ed.), New York, New York: Springer

Template:WH Template:WS