The symptom of St. George - Mussi is observed in inflammatory processes of the biliary tract. Cholecystitis occurs at any age, most often after eating fatty, fried, pickled foods in large quantities.
How to check a symptom?
To cause the Georgievsky-Mussi symptom, it is necessary to press the index finger between the sternum and clavicular processes of the sternocleidomastoid muscle. You need to press gently on the right side. Patients with inflammatory processes of the gallbladder begin to feel a sharp sharp pain in the right hypochondrium. What makes a person feel pain in a remote area? To find the answer to the question will help the human anatomy.
Physiological basis of the symptom
All internal organs are controlled by the central nervous system, which is responsible for the operation of each body system. Inflammation entails a violation of the functions of specialized anatomical sites (heart, lungs, bronchi, liver, etc.), which manifests itself in the form of local pain. But the nerves responsible for a specific organ are also involved in the process. The nerve bundle is located strictly in the region of the legs of the sternocleidomastoid muscle, and neurons are intertwined in it, innervating not only the neck region, but also below the lying organs.
As a result of the pressure, the nerve plexuses are irritated, and then a characteristic pain occurs at the site of inflammation. Recent medical studies have substantiated this phenomenon. The fact is that the liver is controlled by the phrenic nerve, which forms the so-called hepatic plexus. The nerve passes near the sternocleidomastoid muscle, which serves as the pathophysiological rationale for this symptom. That is why the symptom of Mussi - Georgievsky causes intense pain in the gallbladder.
When else is the symptom positive?
The symptom of Georgievsky - Mussi, or the phrenicus symptom, can be positive on the left. This signals a critical condition of the body and serves as an indication for urgent hospitalization. Symptom of Georgievsky - Mussi is duplicated on the left in the case of:
- rupture or injury of the spleen;
- perforation of a stomach ulcer;
- abscesses in the subphrenic region;
- massive internal hemorrhages into the retroperitoneal space (with ectopic pregnancy, mechanical action on the tissue, gunshot wound).
These conditions require emergency medical attention.
The first signs of cholecystitis
The initial symptoms of gallbladder inflammation are characteristic pains in the right hypochondrium, which are accompanied by nausea (sometimes vomiting). Also, body temperature rises to 38 degrees. The bile ducts begin to shrink, as a result of which bile ceases to enter the intestines. The skin begins to turn yellow, and the bowel movements lose their characteristic dark color, becoming melena.
The patient can detect symptoms of Ortner, Murphy, St. George - Mussi. To check the remaining signs, you need to know that the gallbladder is located in the right hypochondrium on the costal arch along the midclavicular line. It is in this place that you need to press with your thumb to check the symptom of Murphy and make sure there is inflammation. The Ortner sign is caused by lightly shaking the palm along the costal arch, where the gallbladder is located.
The symptom of Georgievsky-Mussi with cholecystitis helps even young surgeons to differentiate the inflammatory processes in the gallbladder from appendicitis, peritonitis, ectopic pregnancy, perforated stomach ulcers or small intestines, hepatitis, nonspecific colitis.
What will happen if you don’t help?
The acute period of cholecystitis requires special enzyme therapy. Without proper treatment, the disease acquires a chronic course with phases of exacerbation and remission. The chronicle is much more difficult to cure, since the pancreas and intestines are involved in the process. Moreover, food is poorly digested, which means that the body will not be able to get the right amount of vitamins, fats, proteins, carbohydrates, minerals.
Most often, the symptom of St. George - Mussi signals the severity of the inflammatory process. Complications may be:
- fistula formation;
- the development of acute pancreatitis;
- gallbladder abscess;
- blood poisoning (sepsis).
Even with a slightly positive symptom, it is recommended to contact the nearest hospital in the office of the surgeon on duty.
What to do?
Sometimes, seeking medical help may be impossible, for example, for rural residents. The first thing that can be done for the patient is to give him a comfortable position in bed, which relieves intense pain in the hypochondrium. Then you should check for other signs of cholecystitis. If they are positive, a visit to the doctor will be required. After the first signs appear, smoked meats, pickled vegetables, fatty foods, alcohol should be excluded from the diet. This will help not to aggravate the inflammatory process, to exclude the development of complications.