Continuing normal
PProximal obstruction of A closed-loop
the appendiceal lumen obstruction
Vague, dull, diffuse
pain in the mid-
abdomen or lower
epigastrium
Visceral pain
increases
Perforation occurs
(antimesenteric
border just beyond
the obstruction)
secretion by the
appendicial mucosa Continued
mucosal secretion
Nerve endings of
visceral afferent Distension of the
stretch fibers are appendix
Rapid multiplication
stimulated
of resident bacteria
of the appendix
Causes reflex
Increased pressure
nausea and
in the organ
vomiting
Venous pressure is Capillaries and Engorgement and
exceeded venules are vascular
occluded congestion
Inflammatory process
Allows bacterial Compromised Susceptibility to soon involves the serosa
integrity impaired blood
invasion of the appendix and in
supply of the turn parietal peritoneum
appendix mucosa
Area with poorest
blood supply Characteristic shift
suffers in pain to RLQ
Ellipsoidal infarcts
develop in the
Infarction progress
antimesenteric
border