c

 



is thus caused, initially by the distension of the wall of

the appendix, and later when the grossly inflamed appendix rubs on the
overlying inner wall of the abdomen (parietal peritoneum) and then with the
spillage of the content of the appendix into the general abdominal cavity
(peritonitis).

 is brought about by the release of toxic materials (endogenous

pyrogens) following the necrosis of appendicael wall, and later by pus
formation.

  
 and nausea follows slowing and irritation of the bowel by
the inflammatory process.

The pathophysiology of appendicitis obviously correlates with the clinical

picture.

Acute appendicitis pathophysiology follows the same pattern, even in

children and pregnant women.

In the elderly, the pathophysiology of appendicitis remains unaltered, but

the inflammatory response generated by the elderly is often less than that
seen with young fit individuals, accounting for the often benign presentation
froth with a tendency to miss the diagnosis, thus courting more
complications.