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Episodes of Constipation                Low Fiber Diet
                                    ↓                             ↓
                                                      ↓
                                    Occlusion of Appendix by Fecalith
                                                      ↓
                               Decreased flow/drainage of mucosal secetions
                                                      ↓
                                      Increased ILP in the appendix
                                                      ↓
                                              Vasocongestion
                                                      ↓
                                  Decreased blood supply in the appendix
                                                      ↓
                                   Decreased O2 supply in the appendix
                                                      ↓
                        Appendix starts to be necrotic; Bacteria invade the appendix
                                                      ↓
                                Disruption of Cell Membrane of Appendix
                                                      ↓
                                      Start of Inflammatory Process
                                                      ↓
              ↓                                             ↓                                 ↓
Release of Chemical Mediators                   Activation of the Vomiting           Neutrophils to area
                                                   Center in the Medulla
                                                     ↓                     ↓
   ---> Histamine, Prostaglandin,          Stimulation of Vagus Suppression of          Pus Formation
        Leukotrienes, Bradykinin                    Nerve             Sympathetic (phagocytized bacteria
                   ↓                                                  GI Function    and dead cells)

         Swelling of Appendix                                                               Risk for Infection
                                                                                        (if appendix ruptures)
  ---> Prostaglandin, Bradykinin            Nausea & Vomiting           Anorexia
                   ↓
        Pain in the RLQ of Abdomen          Risk for Deficient    Risk for Imbalanced Nutrition
                   ↓                          Fluid Volume         less than body requirements
              Acute Pain
  ---> Interleukin-1
               ↓
       Increased WBC

                                Inflammation of Appendix (Appendicitis)      <
                                                     ↓
                                              Appendectomy
                                                     ↓
                                              Tissue Trauma

                                                                                            ↓
        Open Wound                   Disruption of Cell Membrane                    Nociceptors on the
       ↓                 ↓                        ↓                                      Dermis
Impaired Tissue      Risk for          Start of Inflammatory                                ↓
  Integrity         Infection               Process                              Send Impulse to CNS


                                      Release of Prostaglandin/                       Pain on Surgical
                                           Bradykinin                                       Site

                                                                                     Activity Intolerance

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pathophysiology-of-appendicitis

  • 1. Episodes of Constipation Low Fiber Diet ↓ ↓ ↓ Occlusion of Appendix by Fecalith ↓ Decreased flow/drainage of mucosal secetions ↓ Increased ILP in the appendix ↓ Vasocongestion ↓ Decreased blood supply in the appendix ↓ Decreased O2 supply in the appendix ↓ Appendix starts to be necrotic; Bacteria invade the appendix ↓ Disruption of Cell Membrane of Appendix ↓ Start of Inflammatory Process ↓ ↓ ↓ ↓ Release of Chemical Mediators Activation of the Vomiting Neutrophils to area Center in the Medulla ↓ ↓ ---> Histamine, Prostaglandin, Stimulation of Vagus Suppression of Pus Formation Leukotrienes, Bradykinin Nerve Sympathetic (phagocytized bacteria ↓ GI Function and dead cells) Swelling of Appendix Risk for Infection (if appendix ruptures) ---> Prostaglandin, Bradykinin Nausea & Vomiting Anorexia ↓ Pain in the RLQ of Abdomen Risk for Deficient Risk for Imbalanced Nutrition ↓ Fluid Volume less than body requirements Acute Pain ---> Interleukin-1 ↓ Increased WBC Inflammation of Appendix (Appendicitis) < ↓ Appendectomy ↓ Tissue Trauma ↓ Open Wound Disruption of Cell Membrane Nociceptors on the ↓ ↓ ↓ Dermis Impaired Tissue Risk for Start of Inflammatory ↓ Integrity Infection Process Send Impulse to CNS Release of Prostaglandin/ Pain on Surgical Bradykinin Site Activity Intolerance