The Pathogenesis of Acute Appendicitis. the Non-Specific Response of the Digestive Tract in Acute Inflammation in the Abdomen
Levin, M.D.
Eksperimental'naia i Klinicheskaia Gastroenterologiia 8: 67-74
2016
ISSN/ISBN: 1682-8658 PMID: 29874439 Document Number: 690727
Based on the analysis of literature and our own studies we propose hypothesis of the pathogenesis of acute appendicitis (AA), which differs from the following generally accepted provisions. Acute appendidtis develops as a result of immunological reaction and hyperplasia of the mucous membrane of the appendix. Frequency peaks related to age, sex, and seasonal changes of AA are due to increased excretion of sex hormones. Only a small percentage of cases of primary hyperplasia causes a complete occlusion of the lumen and destructive AA. Usually it is exposed to regression without causing the typical symptoms, but leaving the damaged nervous system and / or sclerotic changes that violate the peristalsis of the appendix. Faeces, lingering in appendix eventually harden, increasing in size and often get saturated with salts. In the next fit of hyperplasia, the walls are stretched over fecolithe, causing obstruction of the lumen, the formation of a closed cavity and the known mechanisms of inflammation. Inflammation leads to increased tone of the stomach and colon, but strong in the segments of intestine lay next to the A. This is accompanied by increased of the anal canal pressure. Increased tone of the digestive tract is a nonspecific response to acute inflammation. We can assume that the same reaction is observed at any localization of acute and chronic inflammation.