2. PATHOLOGY
The
most important factor in the causation of this disorder
is
obstruction of
the lumen either by a
feacolith or lymphoid
hypertrophy in the wall of the
appendix.
Vegetable matter and intestinal worms
can also be responsible for
obstruction of the lumen.
The
obstruction causes a
closed loop, obstructions
of the
isolated appendix lumen leading to :
Sequence
-
Collection of secretions
within its lumen
causing in
distension which stimulates
the nerve endings and causes
dull visceral pain.
-
There is stasis
and multiplication of
bacteria causing
inflamatory response further distension as also release
of
exotoxins.
-
Stimulation of peristalsis causing a colicky pain.
-
Stagnation of contents leads to further
multiplication of
bacteria which are resident there.
-
Further increase in the
pressure within the lumen of the
appendix.
-
Pressure within the
lumen obstructs the veins
and later
arteries of the appendix and interferes with the blood supply.
-
Necrosis and gangrene of the gangrene of the appendix
with
resultant spreading peritonitis.
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