Appendicitis is the most common gastroenterological disease. Inflammation usually occurs suddenly. Manifestations of appendicitis are diverse and depend on the form of pathology, the age of the patient and the location of the appendix. Also, the symptomatology depends on the presence of chronic gastrointestinal diseases, and in women - pregnancy.
Appendicitis: a description of the disease
Appendicitis is an abdominal pathology characterized by inflammation of the vermiform appendix of the cecum (appendix). In gastroenterology, the disease is considered the most common. Of the total hospital admissions to surgery, 89.1% are appendicitis. The disease occurs in men and women with the same frequency. On average per year, inflammation of the appendix is diagnosed in five out of a thousand people aged 10 to 30 years.
With this frequency of pathology, it is not surprising that some of any discomfort in the abdomen is taken as a symptom of inflammation of the first part of the colon. In order not to panic ahead of time, you should first understand in which side the appendicitis is. To do this, refresh the memory of human anatomy.
The appendix is an embryonic, not fully developed process of the cecum. Its exact location depends on the location of the cecum. Basically, the rudiment is located in the ileum, and can lie above the intestine or lower in the pelvis, but only from the right side to the bottom.
Classification
When unpleasant sensations occur in the stomach, many try to remember which side of the appendicitis, its symptoms and signs. But if the localization is constant, then the clinical signs have differences that depend on the form of pathology.
There are two main forms: chronic and acute. Both that, and another has several options. During acute inflammation of the vestigial organ, the following forms are distinguished:
- Catarrhal (simple). It is characterized by impaired blood and lymph circulation in the process, the formation of purulent exudate in the mucous layer. Manifestations of appendicitis of this form are polymorphic. Pathology can be masked by various surgical diseases.
- Purulent and phlegmonous (destructive forms). Progression of catarrhal appendicitis leads to purulent. A day later, leukocyte infiltration covers the entire thickness of the process wall, which is considered as a phlegmonous form.
- Apostematous. It occurs in about a day, characterized by microabscesses. It manifests itself as acute pain, fever up to 40 degrees.
- Gangrene. It occurs due to the infiltration of the walls of the vessels of the appendix, which leads to their damage and the formation of blood clots. According to statistics, the appendix gangrene is diagnosed in 8.1-8.5% of cases under the age of 20 years, and after 60 - 30-33%.
Chronic appendicitis is quite rare. There are 3 forms:
- residual - an attack of acute appendicitis, ending in recovery without surgical intervention;
- recurrent - repeated attacks of an acute form with minimal symptoms;
- primary chronic - sluggish development of appendicitis without acute attacks.
Causes of occurrence
The defeat of the appendix is caused by a bacterial flora that vegetates in the intestine. In the predominant number of cases, the "culprits" of the development of the pathological process are staphylococci, E. coli, diplococci, anaerobes and others.
The process is rich in lymphoid tissue, which makes it a participant in the processes accompanied by an immune response. The painful manifestations of appendicitis are associated with the activation of the lymphatic apparatus, which leads to swelling of the vestibule and compression of nearby organs.
The presence of pathogenic microflora in the intestine is mandatory. With the help of it, the normal digestion process is carried out. But under certain conditions, bacteria become hostile and cause inflammation:
- Mechanical blockage of the lumen of the appendix. As a result of the excess of the process of the presence of fecal stones in its lumen, the proliferation of lymphoid tissue, stagnation of intestinal contents occurs and inflammation develops.
- Impaired blood circulation. With poor blood circulation in the walls of the appendix, a lack of nutrients occurs, local immunity decreases, which contributes to the activation of pyogenic microbes.
- A certain role is played by the nature of nutrition. With heavy fatty foods, insufficient fluid intake, and a tendency to constipation, excess ammonia, carbon dioxide, and other protein breakdown products build up in the intestines. Such conditions are favorable for the development of pathogenic flora.
The manifestation of appendicitis in adults
Symptoms of inflammation vary with age. Middle-aged people have the most powerful immunity, the body tries to cope with pathogens itself. In children, protective functions are poorly formed, in addition, small patients are more sensitive.
Unlike children, adults know which side of the appendicitis is. But this is not enough to recognize an attack of an acute form of inflammation of the appendix. A distinctive symptom of appendicitis is severe pain in the iliac region on the right. As a rule, she appears suddenly. At first, the pain is spilled or more concentrated under the ribs closer to the umbilical region.
After a few hours, physical suffering intensifies and is more clearly felt in the iliac region on the right. With an atypical location of the appendix, soreness is felt in the lower back, in the pelvic area. The pain is severe, persistent, worse with coughing, laughter. It subsides if you lie on your right side.
The inflammatory process is reflected and affects the digestive organs. Therefore, often the pain is accompanied by signs of dyspepsia (indigestion): nausea, increased gas, upset stool (diarrhea or constipation), vomiting. Intoxication is especially pronounced with purulent, phlegmonous forms.
There is an increase in temperature to 38 ° C for several hours, an increase in heart rate up to 90-100 beats per minute without exercise. In rare cases, inflammation of the iliac and pelvic veins with thrombosis. This can cause pulmonary embolism.
Symptoms of appendicitis in children
The causes of inflammation of the rudimentary process in children are the same as in adults. But the clinical picture is somewhat different.
Most young children do not even know which side of the appendicitis, their symptoms are all the more unknown. In infants under 2 years of age, inflammation of the appendage of the cecum is rarely observed due to the anatomical features of the vestigial organ. The main cause of appendicitis at this age is insufficient development of lymph nodes in the appendix. By 6-8 years, follicles in the lymph nodes are fully formed, the frequency of the inflammatory process in the process of the cecum increases.
The main characteristic manifestation of appendicitis in children, as well as adults, is pain. It is localized in the solar plexus closer to the navel, after a while concentrating in the right iliac region. If the rudiment is located between the cecum and the abdominal wall, pain is given in the lower back. If there is a high medial location - in the right hypochondrium. Older children easily indicate which side is injecting appendicitis. In addition to painful sensations, inflammation of the appendage of the cecum in small patients is manifested in the following:
- Kids with appendicitis are anxious, cry, press their legs to their stomach, do not allow themselves to be examined.
- Due to constant pain, the child refuses to eat.
- Repeated vomiting is observed.
- In older children, constipation is noted, in young children, stool is frequent and loose with mucus.
- For schoolchildren, a symptom of “scissors” is characteristic - a mismatch of body temperature and heart rate.
- With a catarrhal form of inflammation, the tongue in children is moist with a plaque at the root.
- With phlegmonous, the tongue is moist and all white.
- With a gangrenous form, the child's tongue is dry and white from plaque.
Symptoms of appendicitis in pregnant women
Inflammation of the vestigial organ is the most common abdominal surgical pathology in women bearing a child. The disease occurs not only during gestation, but also during childbirth or immediately after it.
The manifestation of appendicitis in girls in position differs depending on the trimester. Symptoms in the first trimester are the same as outside the gestation period. Acute sudden pain in the iliac region on the right is felt. Physical suffering can be paroxysmal or permanent. Nausea, diarrhea or constipation, bloating, abdominal cramping are observed. A woman who already knows about her pregnancy may confuse such symptoms with manifestations of toxicosis. This misconception becomes the reason for a late call to the doctor, and, as a result, ends with spontaneous abortion.
In II and III trimesters, women with appendicitis experience severe blurry pain in the anterior abdominal wall. There is an increase in temperature, frequent vomiting.
Inflammation rarely occurs during childbirth. But if it happens, it is quite difficult to recognize it. Contraction drowns out typical symptoms (pain). Palpation of the right half of the abdomen helps to recognize the pathology: when pressed, the woman experiences severe pain that radiates to her leg.
How to recognize appendicitis at home
Inflammation of the appendage of the cecum is a rapidly progressing disease. Untimely seeking medical attention is fraught with complications. In pregnant women, early recognition will reduce the risk of miscarriage, in the rest - the formation of diffuse peritonitis. There are several ways to determine appendicitis yourself:
- Tactile. A person with signs of appendicitis is laid on his back. The stomach should be relaxed, you can make 2-3 slow deep exhalations. A warm palm is carefully placed on the sore area. Then the hand is sharply pulled. If the pain noticeably intensifies, most likely a person has inflammation of the appendix.
- Provocative method. The patient should be amused or asked to shout loudly, cough. You can also put a little effort into the place where the pain is most felt. If with these actions the pain has become more pronounced and acute, most likely the person has appendicitis.
- The patient needs to lie on his right side and bend his knees. In this position, he must be within five minutes. Then the patient should roll over on his left side and fully extend his legs. It is necessary to ask how a person felt during this time. If he says that lying on his right side the pain subsided, and the coup intensified even more - this is confirmation of appendicitis.
What to do if symptoms indicate appendicitis?
Inflammation of the appendage of the cecum is a fairly common pathology. It can occur in men and women of any age. The main symptom of the disease is pain. With pain in the umbilical region on the right, you should not waste time and find out where and how appendicitis hurts. Also, do not take painkillers. It is necessary to call an outpatient medical team. Only a doctor can make an accurate diagnosis and conduct adequate treatment.
What diseases do appendicitis have similar symptoms
Appendicitis is an inflammatory process that develops in a confined space in close proximity to many internal organs. Manifestations of pathology are often confused with signs of inflammation of other organs.
Differential diagnosis consists in comparing the clinical symptoms of appendicitis with similar manifestations of other diseases:
- Stomach ulcer. The main signs: severe pain in various areas of the abdomen, vomiting, which brings relief, bloating, heaviness in the abdomen.
- Acute cholecystitis is accompanied by severe acute pain in the right hypochondrium, nausea, fever.
- Ileus or bowel obstruction. The disease is characterized by intolerable prolonged pain in the abdomen, delayed stool.
- Acute pancreatitis - epigastric pain. True, unlike appendicitis in the supine position, soreness intensifies.
- Enterocolitis is accompanied by pain in the abdomen, aggravated by tension of the abdominal muscles (laughter, physical activity) with a defecation disorder.
- In pregnant women, appendicitis should be differentiated from pathologies of the gastrointestinal tract, inflammation of the ovaries.
- Ectopic pregnancy. Pathology is characterized by cutting pain at the location of the fallopian tube, high temperature.
Prevention of appendicitis
At the first manifestations of appendicitis, seek medical help as soon as possible. Taking timely action often helps to avoid surgery.
Although no one is safe from the development of inflammation, you can reduce the risk of appendicitis. To do this, you must adhere to certain recommendations:
- follow the diet. Eat less heavy food and more rich in fiber, fruit vegetables;
- consume more juices, water, tea (better than green);
- monitor the stool: regularity, consistency;
- if infectious diseases occur, consult a doctor and not self-medicate. Perform the therapy in strict accordance with the recommendations of the doctor;
- prevent obesity;
- during sedentary work, do exercises that improve blood circulation in the abdomen.
Of course, you should consult a doctor so as not to start the disease.