Appendicitis can take everyone by surprise. Appendicitis syndromes (manifestations) are similar to many other diseases. By the way, this is one of the few diseases that are still diagnosed mainly only by the clinical picture. The only exception is laparoscopy, a minimally invasive examination method that requires good reason. So what are the symptoms of appendicitis? What complications may arise?
What is appendicitis?
Appendicitis is an inflammation of the appendix of the cecum, which can occur with different intensities. Inflammation is a common abdominal disease that requires emergency surgery. Most often, the pathology is diagnosed at the age of 22 to 25 years, but can occur at any age.
According to statistics, in women appendicitis inflames more often than in men. Acute appendicitis, which accounts for almost 90% of cases of acute surgical diseases, is a common cause of peritonitis.
Causes of inflammation
A set of symptoms or appendicitis syndromes are formed for unknown reasons. Doctors still do not understand why some people suffer from inflammation of the appendix, while others do not. At present, only theories of the development of pathology are considered.
The most common hypothesis is infection. In appendicitis, the patient’s analyzes often identify pathogens of various diseases, such as Staphylococcus aureus, Escherichia coli, Streptococcus aureus and several bacteria. These bacteria are normal in the intestines, but under favorable conditions, their active reproduction begins, as a result of which the inflammatory process develops.
Also, the causes of pain in appendicitis may be clogging of the appendix. Congenital malformations contribute to this. Various neoplasms, fecal stones and foreign bodies can clog the lumen.
To stagnation of blood and the development of necrosis of the process contributes to circulatory disorders. Violation of the work of small vessels adversely affects the body, causing inflammation. Excessive mucus formation and further inflammation of the appendix can occur when intestinal motility worsens due to neurogenic reactions.
Medical practice shows that inflammation is more often diagnosed in patients suffering from chronic constipation, some infectious pathologies, and heart and vascular diseases.
In men, appendicitis can become inflamed due to bad habits and latent infections in the body. In women, appendicitis syndrome provokes gynecological diseases. In childhood, congenital abnormalities, for example, narrowing of the lumen of the cecum, often lead to pathology.
The first symptoms of appendicitis
Self-determination of appendicitis is quite difficult. Diagnosis in some cases causes difficulties even for experienced professionals. Adult appendicitis syndromes are similar to signs of poisoning, but without obvious intoxication of the body. Repeated vomiting, dry mouth, weakness, and diarrhea are usually not.
Pain syndrome with appendicitis occurs in the stomach. After four to six hours, the discomfort intensifies, moving to the area to the right of the navel. The temperature rises to 37.2-37.4 ° C. Pain migrations are possible, that is, a condition where discomfort is felt in different parts of the abdomen.
Clinical picture
The most characteristic syndrome in appendicitis is pain under the umbilicus and in the solar plexus. Sometimes the patient is disturbed by discomfort without a certain localization. Pain can be of varying intensity. But gradually its localization becomes more distinct - it feels discomfort in the area of the appendix. When moving, changing body position, sneezing and coughing, sensations intensify. In the future, relief of pain is not possible. This indicates the development of complications (peritonitis).
Similar appendicitis pain syndrome is not specific. Discomfort is characteristic of many other intestinal diseases. In children, for example, pain is noted with infections. To facilitate the diagnosis of a doctor, you need to inform about previous diseases. This will save time.
What syndromes with appendicitis still occur? With inflammation, nausea and vomiting sometimes appear. With an empty stomach in vomit, only fluid and mucus of the corpus luteum. Vomiting usually occurs once. The absence of bile in the vomit indicates cholecystitis, blockage of the gallbladder. A situation is considered dangerous in which, against the background of symptoms of appendicitis (pain syndrome and other signs), repeated vomiting occurs, which does not bring relief to the patient.
Patients are often worried about high temperature (about 37-38 ° C). It is dangerous to increase it to 39-40 ° C and a sharp decrease to critical low rates. A common phenomenon with appendicitis is a syndrome called dyspepsia. This is a violation of the digestive tract, which occurs along with impaired urination. At the same time, urine can acquire an intense shade, the patient develops a strong belching, excessive gas formation, heartburn, and feces may turn black. The latter is a very dangerous symptom that indicates intestinal or stomach bleeding.
Appendicitis can begin with completely different symptoms and fairly mild pain. When taking strong painkillers, pain in acute appendicitis may indicate necrotic changes in the walls of the appendix. Seek immediate medical attention.
Shchetkin-Blumberg syndrome is characteristic in acute appendicitis. After soft pressure on the abdominal wall, you need to tear off your fingers sharply. With inflammation, soreness is felt more strongly when the hand is released, and not when pressure is applied to the stomach. You can also determine inflammation by scissor syndrome. With appendicitis, severe tachycardia occurs against a background of normal body temperature.
You can also detect Asaturian syndrome. To do this, put a fist on the left iliac region, and the right protrudes. The cecum is palpated with the left hand at this time, and in the process you can find a painful point that corresponds to appendicitis. Usually, pain on palpation increases with the patient's position on the left side. Often, pain occurs when pressing in the middle of the abdomen.
Symptoms in children
In children, the risk of developing peritonitis is much higher than in adults, so parents need to pay close attention to changes in the well-being of a small patient.
In infants, appendicitis is extremely rare, the frequency of diagnosing pathology increases after two to three years. Most often, the diagnosis (when it comes to acute appendicitis) is made to children aged 9-12 years, and in general, the peak incidence occurs in 15-19 years.
Appendicitis syndromes in children from birth to five years of age are usually observed as follows: anxiety, moodiness, nausea and vomiting, weakness, drowsiness, dry mouth, thirst, fever, chills, pallor, digestive upset (loose stools or constipation). But the signs listed above can indicate both appendicitis and indicate other diseases. You need to call a doctor anyway.
Already by school age, the same syndromes of appendicitis in children and in adults are observed. The stomach will hurt, the temperature may rise, with a sharp push the patient will experience pain. Typical manifestations account for only 30% of cases, the remaining 70% are atypical. Sometimes the appendix is located elsewhere in the peritoneum. The pain can be in the lower abdomen, and in the stomach, in the back, rectum.
The urgent need to see a doctor is indicated by the following symptoms:
- dry tongue;
- decreased appetite;
- chills;
- fever;
- single or multiple vomiting;
- nausea.
The stool in most cases remains normal, there may be constipation or diarrhea (in rare cases). You need to see a doctor no later than two to three hours after the onset of the attack. If a teenage girl complains of pain, then before the doctor arrives, you need to find out the date of the last menstruation. Pain that is similar to appendicitis may be before menstruation.
With an attack, you can not put a heating pad on your stomach and do warming baths, because heat accelerates inflammation. Do not put enemas that increase pressure on the inflamed area. It is forbidden to give the child any medications or laxative, this can complicate the diagnosis and provoke a rupture of the appendix. You can’t eat, you can give only sweetened water.
What can be confused
Pain syndrome with appendicitis can be confused with many other diseases of the digestive system. This is banal food poisoning, hepatic and renal colic, inflammation of the uterus, lymph nodes in the intestines, acute cholecystitis. Even a doctor cannot always determine with certain probability that a patient has appendicitis.
Possible complications
If you do not contact the medical institution on time and remove the inflamed process, this is fraught with serious complications. After 48 hours, appendicular infiltrate develops, which greatly complicates surgical treatment. If you postpone the operation for a longer period, then an additional inflammatory process will develop. This state requires an open access operation. Subsequent interventions may be necessary. Recovery takes up to two weeks, and recovery will last at least a month. It will be possible to return to normal physical activity only after a year.
The most dangerous complication of appendicitis is peritonitis. Such a situation can even be fatal. Usually in this case, two days after the acute symptoms, a period of imaginary well-being sets in, that is, the patient feels better, he decides not to seek help. But soon the condition worsens with the most serious consequences (destruction of intestinal tissues, acute inflammatory process). If you consult a doctor at the beginning of inflammation, then you can reduce the length of your stay in the hospital to one day and do with a relatively easy operation. In case of complications, you will have to spend in the hospital at best about a week.
Diagnostic measures
The diagnosis is made on the basis of the clinical picture, and is confirmed by blood tests. The most reliable method is laparoscopy. Clarification of the form of the inflammatory process is possible already during the surgical intervention, after which a histological examination of the removed tissues is carried out. When diagnosing from instrumental methods, computed tomography, an x-ray of the abdominal wall, ultrasound, irrigoscopy are used.
Consequences of Late Diagnosis
If you do not diagnose inflammation on time, then the risk of complications in the postoperative period increases. The wound is festering. Also increases the time of the operation, the duration of the rehabilitation and recovery process. Modern treatment methods in most cases can avoid dangerous consequences if the patient is under observation. However, you should not rely only on the professionalism of doctors, because everyone should be responsible for their own health.
Treatment methods
To date, pain syndrome of appendicitis in men, women and children is treated only surgically. Previously, an open abdominal operation was performed, but this is always a difficult test for the body, complex rehabilitation and a significant deterioration in the quality of life in the postoperative period. In most cases, appendicitis is operated laparoscopically.
Using a special tool, you can inspect and operate the internal organs. An experienced doctor with this method can even operate on five-day appendicitis, which greatly facilitates the life of the patient. By the way, laparoscopy is also an optimal diagnostic method. What looks like appendicitis, in fact, may turn out to be another disease, which will be revealed already during the operation. Previously, appendicitis was only removed, so it was not possible to use such a diagnostic method.
If there are no complications, then appendicitis syndromes in adults do not require the introduction of antibiotics. In the presence of an inflammatory process in the pelvis, antibiotic therapy is prescribed. A combination of several groups of antibacterial drugs is usually prescribed. Complicated appendicitis requires the introduction of antibiotics.
Useful tips of the surgeon
Doctors advise in no case to self-medicate in the presence of symptoms similar to appendicitis. Do not take any medications (especially anti-inflammatory, painkillers or antispasmodics), because this can complicate the diagnosis. Timely access to a doctor will significantly speed up recovery and recovery after surgery. It is important that appendicitis cannot be cured with medication, only surgery is needed. By the way, there is a huge plus in the treatment of the appendix - having become ill with it once and having recovered, you can forget about appendicitis forever.
Chronic appendicitis
Chronic appendicitis is a sluggish form of inflammation, which is most often associated with a previous acute inflammatory process. The clinical picture is characterized by aching pain, abdominal discomfort, diarrhea or constipation, flatulence. Diagnosis is based on the exclusion of other causes that may provoke such symptoms. Treatment with an unexpressed clinical picture is conservative.
Prevention of appendicitis
To prevent the disease, it is necessary to timely treat various gastrointestinal pathologies, constipation, eat right, and avoid overeating. For alarming symptoms, you need to see a doctor, because even a slight malaise can indicate a serious illness. In general, a healthy lifestyle is recommended.