abdominal panniculitis

- [voiceover] so herewe have our vascular man and he's got blood vessels that supply every part of the body. he's got blood vesselssupplying the heart, blood vessels supplying the lungs, some supplying the kidney, the liver, the intestines, the skin, the nerves, really all over the place. so here's a blood vessel i'm drawing,

of course your blood vessels will be carrying blood, but they also carry nutrients and oxygen and all sorts of proteins. now what happens if theseblood vessels get damaged, or inflamed? what if the inside of the wall of the blood vessel gets very inflamed? well intuitively it makes sense,

blood will not be able topass as well through here and be delivered to the different organs. you know the intestines,the livers, the lung. all of the organs of the body need blood and need nutrients. this damage is precisely what happens in the disease known as vasculitis. vasculitis is damage of blood vessels and inflammation of blood vessels.

itis means inflammation and vascul means vasculatureor blood vessels. essentially this damage iscaused by the immune system. white blood cells mistakenlyrelease small molecules that can damage the blood vessels. essentially the immunesystem makes a mistake and thinks that blood vessels are foreign. so vasculitis is an autoimmune disease. now i know what you're probably thinking,

you might be thinking if i destroy all my blood vessels, how is that compatible with life? well there are differenttypes of vasculitides, the plural for vasculitis and these different typesmight affect different parts of the body. for example one type ofvasculitis might affect the lungs and the kidneys only.

another type might affectthe intestines, the kidney, the heart and the lungs and still another type might only affect the big blood vessels thatcome out of the heart. the different organs affected in patients lead to the differentsymptoms that you might see. for example loss ofblood flow and nutrients to the heart tissuemeans heart cell death, this is known as a heart attack

and this might causesymptoms such as chest pain. the severity of symptomsmight also be different, so for example with abdominal pain a patient might have a range from a small amount of blood in their stool to full on bowel perforation. this all depends on how severely the blood vessels are damaged. now along with these local symptoms

patients might alsoexperience general symptoms such as night sweats or fever, so there's a littlethermometer right here, as the patient might have a fever or the patient might have chills or generalized muscle aches, or they may also experience lethargy or a feeling of being very tired. this all comes from what'scausing this problem,

remember white blood cells are releasing little immune molecules, these immune moleculescan travel down to the rest of the body. these immune molecules are normally used to fight off pathogens and so a patient might feel like they have a general illness or a virus. now let's take a step back.

why are only certaintypes of vessels affected in vasculitis? the different types ofvessels that are affected usually depends on thesize of those blood vessels and so vasculitis has been classified into three different categories. large vessel vasculitis, medium vessel vasculitis and small vessel vasculitis.

here i'll draw a blood vessel to show a little bitabout what's going on. here let me draw this large blood vessel and i've got the blood vessel wall and the outside and theinside of the blood vessel, out and in, and of course on theinside you have the things i have mentioned before. blood, oxygen, nutrients, that all travel

through your blood vesselslike water through pipes. now the purpose of large blood vessels is to get blood distributed quickly through the body to where it needs to go. so if we have inflammation and damage of the blood vessel wall so it's bulging out frominflammation, swelling, scaring and then repeating that process, the blood trying to passthrough can't do so effectively

and so there's decreased blood flow and also after this constrictionyou'll see decreased blood pressure as well. and now a physicianlistening over the skin using a stethoscope mayactually hear this blockage, it's the same thing that happens when you put pressure on a hose. if you put a kink in the hose, not only will water stopflowing through as quickly

but also if you listen at the kink you can hear that bloodtrying to rush through and that's the same thingthe physician hears. this is known as a bruit and if the physician feels the area they may also feel what's called thrill, this feeling of blood rushing through. now for medium sized blood vessels . when scaring occurs for these vessels

it can potentiallyblock flow all together. this leads to blood cells kind of getting stuck behind the blockageand little proteins in the blood known as clotting proteins can form a clot andcompletely stop blood flow. along with clot formation, you can also see the bloodvessel wall bulge out. this is due to increased pressure, the blood has nowhereto go so it pushes up

against the walls. and since medium sized bloodvessel walls are thinner they are prone to this bulging. it's kind of like whenyou take a water balloon and squeeze it on one area, all the water bulges toone side of the wall. the bulging and weakeningof the blood vessel walls are known as aneurysms. the most fear complicationfrom aneurysms is rupture,

leading to blood spillingout of the blood vessels. last of all the finalclassification of blood vessels are small blood vessels. and by small i meanmicroscopic so we've got blood cells marchingthrough nearly single file and a very thin blood vessel wall. you can imagine that damage to this wall can lead to breakage of theblood vessel really easily and depending on where the blood vessel is

that's where you might see symptoms. for example if the small bloodvessels are in the intestines you might see bloody stool. if the blood vessels are in the kidneys you might see bloody urine. if the blood vesselsare just under the skin you might actually see a rash that kind of gives a dotted patternwhere all these different small little blood vessels have ruptured.

so in general the symptomsyou see in vaculitis depends on where the blood vessels are that are affected, whatsize they are and how sever the damage is.