Statistics show that in the field of surgery, appendicitis is the most common disease and accounts for 90% of all operations. This pathology does not choose people either by age or by gender.
Appendicitis goes through several stages. Catarrhal appendicitis is a reversible stage. It occurs in 90% of cases, it is often called simple appendicitis.
Etiology
Clinical medicine experts identify several reasons that provoke the development of pathology:
- pathogenic microorganisms existing in the body;
- intestinal bacteria;
- improper operation of the appendix with contractile movements;
- ingestion of particles, undigested food and calculi;
- inflammatory processes in other organs, which eventually switch to the appendix.
The theoretical basis of risk factors
In fact, modern doctors have not agreed on why catarrhal appendicitis occurs. There are several theories of the origin of the disease, and each has the right to exist:
- Mechanical theory. It is assumed that the disease occurs against a blockage of the process with fecal stones, tumors, and even worms. The inflammatory process can begin against the background of an inflection of the process or develop in the presence of adhesions in the abdominal region.
- Allergic theory. It is believed that with the onset of the 3-4 type of allergic reaction, the protective functions of the walls of the process are significantly reduced, and microbes and bacteria penetrate there without any problems, as a result, the inflammatory process begins.
- Infectious Theory. This theory strongly intersects with the mechanical one. It is believed that infectious agents must be present in the body for inflammation of appendicitis .
- According to vascular theory, it is assumed that catarrhal appendicitis appears against the background of the development of systemic vasculitis on the walls of the appendix's vessels.
- Alimentary theory. It is based on the assertion that the development of the disease is associated with malnutrition. There is a disease against the background of the use of a large amount of protein while reducing fiber intake. As a result, the process of passing food through the intestine is complicated, the inflammatory process begins.
Adherents of different theories converge in the existence of several major risk factors for the development of pathology. These include:
- infectious diseases;
- bad habits;
- gastrointestinal injuries;
- malnutrition;
- dysbiosis.
Pathogenesis
Symptoms of catarrhal appendicitis have many common features with signs of diseases of the abdominal cavity.
Simple appendicitis is superficial, and infiltration is present only on the mucous membrane. At the beginning of the inflammatory process, pain is observed in the navel. Over time, in most patients, pains begin to migrate, appear on the right side, and are given to the rectum. When you try to turn to the left side, pain in the side intensifies.
The localization of pain largely depends on the location of the appendix. A huge influence on the symptoms is also exerted by the general state of health of the patient.
In addition to pain, an increase in body temperature is observed. Diarrhea may begin, or, conversely, constipation. Often there is dry mouth, vomiting, and general weakness throughout the body.
At the first suspicion of acute catarrhal appendicitis, you should immediately contact a medical institution. With young children, things are much more complicated, they can not talk about their feelings. Therefore, parents should pay attention to the behavior of the baby: he becomes lethargic, capricious, often puts his hands on his stomach, sleeps poorly, his temperature rises.
Stages of the disease
Four stages of the disease are distinguished, depending on the neglect of the disease:
- Catarrhal form of appendicitis or the first stage. Symptoms appear in the evening or at night. A lingering pain appears in the stomach, later vomiting begins. It may seem to the patient that gastritis has begun, the stomach is soft, and the pain gradually moves to the right side. The stage lasts about 12 hours, and this is the most favorable period for the operation, but at this stage rarely anyone seeks help.
- The next stage is catarrhal phlegmonous appendicitis. This stage lasts about a day. The pains become pulsating, the heart beats faster, the body temperature rises, but no higher than 38 degrees. On palpation, hardening is observed on the right side of the lower abdomen.
- The gangrenous form begins already on the second or third day after the onset of the first symptoms. The process of dying off the nerve endings of the organ develops, so the pain subsides. Body temperature drops to 36 degrees. Increased pain is characteristic only for palpation.
- At the last perforating stage, through holes appear in the organ. The pains are constant and severe. Bloating, tachycardia are observed. A dark brown coating appears on the tongue.
Forms of ailment
Two main forms of the disease are distinguished: acute and secondary catarrhal appendicitis.
The first form is named so because during it the inflammatory process quickly develops. This pathology occurs most often, without choosing a patient by age or gender. As a rule, the process is blocked by feces, helminths or foreign bodies.
And about the second form, it should be noted that secondary catarrhal appendicitis is such a pathology that is a consequence of the transition of the inflammatory process to the appendix from other organs: the stomach, gall bladder.
Diagnostic measures
If you suspect an appendicitis, you should immediately contact a medical institution. The doctor collects an anamnesis and conducts an examination. There are several methods that allow you to establish an initial diagnosis.
First of all, the patient is asked, when he is in a horizontal position, to turn on his left side. If at the same time the pain intensifies, then, most likely, that the diagnosis is really correct, this symptom is called a Sitkovsky symptom.
Rowzing's symptom consists of the fact that when the patient squeezes the sigmoid colon, severe pain begins. The Moscow symptom is understood as a condition in which the patient's pupil dilates slightly in the right eye.
Be sure to take material for a blood test and urine.
Instrumental diagnostics may also be required, in particular:
- Ultrasound
- CT, MRI;
- radiography.
Instrumental techniques allow you to 100% make an accurate diagnosis.
If the diagnosis is made too late or inadequate treatment has been prescribed, then there is a high risk of developing sepsis, the appearance of internal bleeding or the formation of adhesions.
Differential diagnosis
In most cases, differential diagnosis is required to clearly establish the diagnosis. After all, at any stage of catarrhal appendicitis, the symptoms can be too similar to the signs of other diseases:
- cholecystitis;
- pancreatitis
- ulcer;
- gastroenteritis and others.
That is, in order not to confuse the inflamed appendicitis with other diseases in the abdominal cavity, a differential diagnosis is performed.
Treatment
As soon as there is a suspicion that the incoming patient has inflammation in the area of appendicitis, then he is immediately sent to the surgical department. After this, all examinations are urgently carried out, allowing you to clarify the diagnosis and provide assistance.
Many are interested if catarrhal appendicitis is diagnosed, whether surgery is needed. Alas, surgical intervention is indispensable.
To date, surgery can be performed laparoscopically, transluminally or lapartomically.
Most often they use the first technique, it is not so traumatic for the patient. The surgeon makes small punctures through which he removes the inflamed process. The transluminal method involves the removal of appendicitis through the stomach or vagina.
Laparotomy surgery is most often performed with a secondary form of the disease or if there are suspicions that other organs are affected. In such cases, an incision is made up to 10 centimeters long, and the damaged organ is removed. At the same time, the doctor can clearly see if there are problems with other internal organs.
If during the operation no complications arose, the recovery process lasts no more than 10 days. In the recovery period, the patient is prescribed antibacterial agents, if necessary, pain medication.
Rehabilitation
For several months after the removal of appendicitis, it is necessary to follow a diet. 12 hours after surgery, the patient can drink broth, jelly or tea. And on the second day it is transferred to fractional 6 meals a day. A detailed diet for the patient should be a doctor.
In the process of rehabilitation it is allowed to use vegetable soups with onions, potatoes, carrots. Suitable pasta, mushrooms, baked vegetables, lean meat and fish, boiled and steamed. Fat-free dairy products, fruits and herbal teas can be consumed.
It is imperative to exclude smoked meats, pickles, seasonings, sweets, borsch, fatty broths and meat.
During the rehabilitation period, it is recommended to take daily walks, visit the pool or engage in other light sports. If the patient is overweight, then you may have to wear a bandage for some time.
Prevention
To date, no clear reasons have been identified why exactly catarrhal appendicitis appears. For this reason, there are no effective preventive measures. However, doctors recommend not to abuse alcohol, not to get involved in “junk” foods, eat rationally, as far as possible, eat foods high in minerals and vitamins.