Editing Appendicitis (section)

== '''Pathophysiology''' ==

* Appendicitis is caused by     luminal obstruction, which rapidly causes a closed loop and greatly     increased pressure due to continued mucus secretion and production of gas     by bacteria
* Progressive distension causes     venous outflow obstruction, leading to first mucosal and then     full-thickness ischaemia, and then perforation
* Perforation usually occurs     just beyond the point of obstruction, where pressure is greatest
** It can take anywhere from a      few hours to a few days to perforate, but only 20% perforate in the first      24 hours, and 65% perforate after 48 hours
** Leads to either free      perforation or formation of an abscess
** Abscess - acute inflammation      with walled-off pus
** Phlegmon - acute      inflammation in soft tissue with no loculated drainable collection
* Bacterial overgrowth due to     distal stasis in appendicitis means that the released inoculum of bacteria     is large and variable
** Similar bacteria to that      within the colon
** Infections should be      considered polymicrobial - need to treat primarily gram-negatives and      anaerobes