Detecting endothelial dysfunction by hemostasis testing in acute appendicitis

Endothelial dysfunction plays a critical role in the pathogenesis of various acute and chronic conditions. It is a pathological state characterized by progressive damage to endothelial cells and their function. Endothelial dysfunction has long been studied in various disorders using several methods. It is caused by pro-inflammatory and prothrombotic factors. Coagulation disorders are not always detected by routine coagulation tests, and their nature is unclear. Published data indicate that hypercoagulation is expected in inflammation. However, local inflammation does not always result in thrombogenesis, causing a prethrombotic state. Assessment of the coagulation system is required to confirm a prethrombotic state. Changes in thromboelastometry findings may be used to assess the degree of endothelial dysfunction, which may depend on the severity of inflammation. Therefore, thromboelastometry findings may be clinically significant for determining the degree of endothelial dysfunction in various forms of acute appendicitis and for evaluating the risk of complications. This study investigated the pathogenetic aspects of acute appendicitis that are associated with endothelial dysfunction, particularly latent hypercoagulation and its detection. Review of published data emphasized the need for further research on the subject. Research into the pathophysiology of coagulation disorders as a manifestation of endothelial dysfunction will provide better understanding on the pathogenetic aspects of acute abdominal diseases.