Appendicitis may be caused by the blockage of the lumen of the appendix by lymphoid follicle hyperplasia, fekalit, foreign bodies, strictures due to fibrosis from previous inflammation or neoplasm. Yahng feces trapped in the lumen apeneiks will cause obstruction and absorption of water and would have formed a movement that eventually fekolit blockage. Obstruction that occurs causes the mucus to be produced mucosa suffered dam.
The longer semakib much mucus, but the elasticity of the wall of the appendix has limitations that lead to increased intraluminal pressure. These pressures will impede the flow of lymph resulting in edema, diapedesis of bacteria and mucus ulceration. At this time there is a focal acute appendicitis is characterized by epigastric pain. Blockages caused pain around the umbilicus and epigastrium, nausea, vomiting. Invasion of bacteria E. Coli and spesibakteroides from the lumen to the mucosal layer, submucosal, muskularisa layer of the parietal peritoneum and finally to the lower right there was local peritonitis. Body temperature starts to rise. When the secretion of mucus continues belanjut, the pressure will continue to increase. This will cause venous obstruction, edema and bacteria will grow through the wall. Inflammation of the peritoneum arising widespread local and causing pain in the lower right area. This situation came to be called with acute suppurative appendicitis. When disturbed arterial flow and myocardial wall of the appendix will be followed by gangrene. This stage is called appendicitis gangrenosa. When the walls that have been fragile rupture, will lead to perforated appendicitis. When the process is slow, omentum and the adjacent bowel will move toward an appendix to the arising of a local mob called appendicular infiltrate. Inflammation of the appendix will be cause abscesses or even disappear. In children because of the shorter omentum and appendix are longer, thinner wall of the appendix. Circumstances, coupled with the immune system is lacking facilitate the occurrence of perforation. Whereas in older people perforation easily occurs because there has been disruption of blood vessels.Inflammatory stage of appendicitis:
- Akuta appendicitis (simple, without perforas)
- Appendicitis akuta Perforate (including appendicitis gangrenosa, because the wall is already happening mikroperforasi appendix).
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