Gangrenous appendicitis is a pathology that is characterized by tissue necrosis of the vermiform segment and a typical clinical picture, which makes it possible to differentiate it from other forms of the inflammatory process directly in the appendix. Most often, it is acute and provokes develop quite serious health consequences. That is why it is so important to seek help from a doctor in a timely manner, who will determine the causes of the pathological process and prescribe therapy.
General information
Gangrenous appendicitis is a type of purulent process inflammation of the process, which is based on irreversible destruction. Most often, changes in the necrotic nature are observed in small areas of the appendix. Gangrenous inflammation is a form of the acute variant of the disease and appears only at a certain stage of its development (2-3 days of inflammation).
The main causes of the development of pathology
Acute gangrenous appendicitis develops when the inflammatory process in the appendix has not been noticed during the first day. Then the normal sensitivity of the nerve endings disappears, so the pain syndrome may disappear. Many patients decide that the danger has passed, you can postpone a visit to the doctor for some time. Such neglect of one's own health can lead to peritonitis.
The main risk factors for the occurrence of such a pathology are the following:
- Elderly age.
- The formation of blood clots.
- Atherosclerosis of the intestinal arteries.
All these factors indicate that the direct causes of the development of pathology are the so-called microcirculatory disorders. Their result is a violation of normal circulation, as a result - necrosis of the appendix. Other elements of pathogenesis (infection, autoaggression of immune cells) attach only secondarily, only exacerbating the course of pathology.
What signs indicate a pathology?
In the acute period, repeated vomiting occurs, which constantly exhausts the patient and does not bring long-awaited relief. Due to intoxication of the body due to the development of a putrefactive inflammatory process, the temperature may remain normal or low.
Gangrenous appendicitis is manifested in the form of "toxic scissors" syndrome. The patient has severe tachycardia (heart rate of about 100 beats per minute), but the temperature does not rise.
The patient's tongue is dry with a characteristic yellowish coating. In the case of primary gangrenous appendicitis, the symptoms may vary slightly:
- Pain discomfort in the right iliac region, which suddenly appears and quickly subsides.
- The abdomen is hard, painful.
- The patient's condition is regarded as serious.
If a person does not receive adequate and timely treatment, after this form of the disease gangrenous-perforated appendicitis develops. Pathology is characterized by perforation of the wall itself of the appendix. During his immediate rupture, a person experiences severe pain, which over time begins to gradually spread throughout the abdomen. Due to increasing intoxication of the body, the temperature rises, there is a clear tachycardia. The tongue becomes very dry, the coating becomes brownish. The patient suffers from severe vomiting.
Diagnostic measures
If you have the above symptoms, you should immediately seek help from a doctor. If this pathology is suspected, the specialist initially conducts a physical examination of the patient. On palpation, as a rule, tension of the abdominal wall is observed, the abdomen is moderately swollen. A series of laboratory tests are then prescribed, including a blood and urine test. Additionally, ultrasound , x-ray, and computed tomography may be required. Based on the test results, the doctor can confirm the diagnosis of gangrenous appendicitis.
Treatment methods
Therapy involves surgical removal of the appendix. Appendectomy is carried out in the traditional way or through laparoscopy.
In the first case, the doctor removes the appendix through the incision in the abdominal wall. Typically, this procedure is performed using general anesthesia.
The operation for appendicitis through laparoscopy is not very traumatic. The surgeon makes several microscopic punctures in the abdominal wall through which the instruments for manipulation are introduced. The most important of them is a laparoscope - a tube with a camera at the end. During the operation, the doctor receives an image from her on the computer screen, which allows the most accurate surgical procedures.
Postoperative period
The postoperative period in patients with such a fairly common diagnosis has a number of features:
- The use of antibacterial and painkillers.
- Detoxification infusion therapy using saline solutions, reformed, glucose and albumin.
- Daily blood tests.
- Prevention of ulcers and thromboembolic complications. In the postoperative period, patients are prescribed gastric secretion blockers (Kvamatel, Omez), anticoagulants (Kleksan).
- Daily dressings and washing of wounds.
- Exercise therapy, special massage, breathing exercises.
Operation on appendicitis is a fairly serious surgical intervention. To prevent future complications, you should use the recommendations below.
Talk about nutrition
This pathology is characterized by problems with intestinal motility, therefore, after surgery, special attention should be paid to nutrition.
On the first day, the use of low-fat kefir, mineral water without gases and light chicken broth is allowed. On the second day, if the postoperative period is not complicated by negative consequences, you can add mashed potatoes, liquid cereals on the water and cottage cheese casserole to the diet. A day later, nutrition must be diversified as part of diet No. 5. It is better to refuse fatty, spicy foods and smoked meats.
Probable complications
This pathology is considered very dangerous, as it can lead to the development of rather dangerous health complications. This process is especially critical for small patients.
What are the negative consequences of gangrenous appendicitis?
- Purulent peritonitis. This is a rather dangerous condition that requires immediate surgical intervention. If help is not provided in a timely manner, blood poisoning may occur.
- Appendicular infiltrate. In the area of the inflamed process, a local conglomerate is formed, consisting mainly of organs and tissues. This problem always requires prolonged conservative therapy.
- Septic thrombophlebitis. The inflammatory process develops in the venous walls. As a result, it leads to the formation of blood clots in the lumen of the vein.
- Local purulent abscess. Such formations mainly develop in the diaphragm zone.
Appendicitis should not be ignored. A purulent gangrenous version of this pathology requires immediate treatment. Otherwise, the likelihood of developing complications and even death increases. Such inflammation is especially dangerous for children, they have all the pathological processes proceeding several times faster.