Predisposing factors - Age: 10 -30 yrs old - Gender: male (2:1

)

PATHOPHYSILOGY of APPENDICITIS Precipitating factors: - Constipation/IBD - Diet (low fiber) LEGEND: + Bold +

signs & symptoms Underlined intervention - not experienced by the patient - medical procedure or

Fecal obstruction

+ Occlusion of Appendix by Fecalith Increased ILP in the appendix Vasocongestion Hypoxia in the appendix Pain Pyrogens Hypothalamus Fever

(prostaglandin production)

Appendix starts to be necrotic; Bacteria invade the appendix Disruption of Cell Membrane of Appendix Start of Inflammatory Process Activation of the Vomiting Center in the Medulla

Mast Cells lammation of Appendix (Appendicitis)

Appendectomy Bradykinin Prostaglandin Tissue Trauma vasoconstriction

Histamine

Leukotrienes

interleukin - 1

Stimulation of vagus nerve GI function

suppression of sympathetic

vasodilation Nociceptors on the dermis membrane accumulation of WBC

increase WBC

Nausea and vomiting

anorexia disruption of cell

18.30 x 10 /L
increase permeability

9

start of

inflammatory process send impulses to the CNS to the interstitial compartment Phagocytosis swelling of Abdomen pain. heat & redness swelling DEATH Pain RECOVERY the swelled appendix .decreased Blood Volume strong antibiotic and fluid replacement pain.decreased Blood Pressure . & weight loss Septic shock: Exudates rupture of Peritonitis sepsis (septecemia) Appendectomy with Explore Laparotomy If treated if NOT treated . swelling.

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