Appendicitis is a rather dangerous disease with its consequences. Therefore, the main task of a specialist is to diagnose him as quickly and more accurately as possible. A number of symptoms, named after the researchers who first identified them, help to recognize the disease - the symptoms of Rozing, Sitkovsky, Bartomier-Michelson, Voskresensky and so on. Let's get to know them in more detail.
Causes of appendicitis
There are several causes of appendicitis:
- Blockage of the entrance to the vermiform end of the rectum is the most common. This can happen due to the ingress of foreign bodies, feces. Clogging can also occur from squeezing the upper part of the appendix with the formation of adhesions during enteritis and cholecystitis.
- Stagnation of the contents of the appendix. This leads to a weakening of its protective functions, which is why pathogenic bacteria - staphylococci, Escherichia coli, streptococci begin to multiply in the appendix. They cause inflammation.
- Spasm of blood vessels that supply blood to the appendix.
- Injury to the peritoneum, which can lead to displacement or damage to the appendix.
- Pregnancy. The process can shift due to the growth of the uterus.
- Tendency to constipation.
- Poor intestinal motility.
- Binge eating.
- Lack of plant fiber, trace elements, vitamins in the diet.
- Gastrointestinal diseases.
- Hereditary factors.
- Infectious diseases.
- The presence of parasites.
- Bad habits.
- Stress.
About the diagnosis of appendicitis in Russia
Appendicitis is an inflammation of the vermiform appendix of the rectum. For its initial diagnosis, confirmation or refutation of the diagnosis, doctors in Russia use certain symptoms of peritoneal irritation that have been tested for years. There are few of them, but they are the reliable "old-timers" in clinical practice. Named by the name of their author:
- Symptom of Sitkovsky.
- Symptom of Kocher.
- Symptom of Resurrection.
- Symptom Obraztsova.
- Symptom of Rowzing.
- Symptom Shchetkina-Blumberg.
The manifestation of each of them depends on a number of factors: the location of the appendix, the causes of inflammation, the neglect of the disease, etc. We will analyze the Sitkovsky symptom and others in more detail.
Symptom of kocher
The surest sign by which acute appendicitis can be determined is Kocher syndrome. Among doctors there is even an expression: "Kocher does not lie." In half of patients suffering from appendicitis, this symptom is revealed.
It manifests itself in the following: pain from the epigastric region gradually migrates to the right ileal. It is determined during the taking of an anamnesis, a patient survey - specifying the place of occurrence of the pain syndrome, its nature.
Symptom of Sitkovsky
With appendicitis, doctors still overwhelmingly give preference to this symptom. The main reason is that it can be checked quickly and easily.
The manipulations are as follows: the patient is asked to lie on his left side and describe his feelings. With this movement, the intestinal loops are displaced, dragging along the inflamed process. Therefore, the patient in the presence of appendicitis will inevitably complain of an increase in pain.
Symptom of Resurrection
Another name is "shirt symptom." The sign helps to diagnose not only appendicitis, but also other inflammatory processes of the abdominal cavity. Therefore, in clinical practice, it is popular no less than Sitkovsky's symptom.
It is checked as follows: on a slightly stretched shirt, which is worn on the patient, quickly pass the edge of the palm of his hand over several areas in the abdomen. If with these actions the patient will feel pain in the right iliac region, then he can be diagnosed with appendicitis.
Symptom Shchetkina-Blumberg
Another sign of peritoneal irritation, not inferior to the Sitkovsky symptom. It is considered a valid test for peritonitis, which is why it is used for all complaints of abdominal pain.
The following actions are required: the doctor slowly puts his palm on the patient’s front abdominal wall and presses gently, without effort. Then abruptly removes his hand. If at the same time the patient felt a sharp pain, then the symptom of Shchetkin-Blumberg was confirmed. In the acute form of appendicitis, the patient will feel pain during this precisely in the iliac right region.
Symptom of Rowzing
It is rarely used in practice, which does not negate its fidelity, which is why the literature constantly mentions the symptoms of Rowzing and Sitkovsky. It is determined when pain occurs with the accumulation of gases in the rectum.
The doctor performs the following manipulations: it is necessary to squeeze the colon of the descending colon in the left ileal part of the peritoneum with a lying patient. At the same time, with your right hand perform jerk-like pressures a little higher. If with such a change in pressure in the intestinal tract, the patient feels pain in the iliac right region, then he is diagnosed with appendicitis.
Symptom Obraztsova
After we talked about the symptoms of Rovzing, Sitkovsky, Voskresensky, it will not be out of place to tell about the sign of Obraztsov, which helps to identify the retrocecal location of the appendix.
The patient is asked to lie on his back and raise his right leg, straightened at the knee. At this time, the muscles of the anterior abdominal cavity and lower back tighten and begin to act on the receptors of the appendix. If the latter is inflamed, the patient will complain of pain in the right iliac region.
Other symptoms
We analyzed a number of appendicular symptoms, a Sitkovsky symptom. We will get acquainted with the less common, but taking place in medical practice, methods for diagnosing acute inflammation of the appendix:
- Symptom of Bartomier-Michelson. The patient lies on his left side, and the doctor, palpating the right side of the peritoneum, finds a painful place.
- Symptom of Varlamov. When tapping in the region of the right XII rib, pain occurs in the characteristic right side of the peritoneum.
- Symptom of Ben Asher. The doctor presses the tips of two fingers into the left hypochondrium of the patient. The patient is asked to breathe deeply or cough. If during this manipulation there was pain in the right iliac region, there is a suspicion of appendicitis.
- Symptom of Asaturian. The doctor presses with his fist on the left iliac region of the patient. On the protruding right region with a free hand, the specialist palpates the cecum to localize the pain.
- Bassler's symptom. Soreness is determined by pressing between the upper anterior spine of the ilium and the navel towards the spine of the bone.
- Symptom Iliescu. Soreness in the characteristic zone occurs when pressure is placed on the cervical point of the right diffragmental nerve.
- Symptom Brendo. It is used in the diagnosis of appendicitis in pregnant women. When pressing on the left uterine rib, pain occurs in the right area of the peritoneum.
- Zatler's syndrome. A patient in a sitting position is asked to straighten his right leg. With inflammation of the appendix, the patient will feel pain in the right iliac region during this movement.
- Symptom Cope. With rotation of the right thigh, pain in the right iliac region is intensified.
The effects of acute appendicitis
Complications of appendicitis are divided into two groups:
- Preoperative. Their reasons:
- The patient held out with a call for medical help.
- The attending physician misdiagnosed.
- The operation was performed with errors.
- Inflammation has given rise to new diseases or chronic development.
- Postoperative. Their reasons:
- Failure to follow the doctor's recommendations after surgery.
- Inflammation of the surgical wound.
- Inflammation of adjacent organs, peritoneum.
Thus, appendicitis is not the most dangerous inflammatory process that can be easily eliminated by surgery. The following complications are terrible:
- Perforation is an early type of complication, developing along with peritonitis. It is characterized as purulent fusion of the walls of the appendix and the outflow of pus into the abdominal cavity.
- Appendicular infiltrate - develops in patients who seek help late. This is the spread of inflammation from the appendix to neighboring organs.
- An appendicular abscess is a rare form of complication. This is purulent inflammation in the right iliac region, between the loops of the intestine, under the diaphragm, in the retroperitoneal space.
- Pilephlebitis is a severe purulent-septic inflammation of the portal portal vein of the liver, in which many ulcers form. Danger of death.
- Peritonitis is an inflammation of the peritoneum.
- Intestinal fistulas are the result of surgery errors. This is an accidental lesion of the intestinal loops when the appendix is removed.
We examined the disease with which a symptom of Sitkovsky, Obraztsov, Voskresensky and so on is observed. As you have seen, with the help of these diagnostics, appendicitis can be easily and quickly determined in a patient.