Today, many people know whether it is possible to die from appendicitis. The disease is treated surgically, and many are scared. Is it possible to refuse an operation if inflammation has begun? Doctors believe this is extremely unreasonable. If you do not agree to urgent surgery, appendicitis will cause peritonitis, which is highly likely to be accompanied by mortal risks for the patient.
About numbers
As statistical studies show, over the past few decades, the number of complications accompanying appendix inflammation has markedly decreased. The frequency of fatalities has also decreased significantly. To date, mortality from appendicitis is estimated at two hundredths of a percent of the total number of people with appendicitis. However, such indicators do not characterize the most economically prosperous areas, which are characterized by a fairly low development of infrastructure. An amazing paradox is taking shape: the better the living standard of a person, the better the terrain, the more careless a person is about his health, considering that it is never too late to visit a doctor.
Figures and countries
Some time ago, studies were organized in our country to estimate the number of deaths from appendicitis. We found that since 1998 over the next four years, the incidence of acute appendicitis has changed (per 10 thousand people) to 22.8 cases, while in the period from 1962 to 1969 among ten thousand The population was approximately 51 suffering. Such values turned out to be characteristic of most regions of the country.
In America about 250 thousand patients are officially met from year to year. In total, this is about a million bed-days in hospital conditions. The incidence rate has been declining since the 1940s, today about a dozen people with an acute form are observed per one hundred thousand people.
In different powers, the average incidence rate is estimated at 7%. Studies on how many people die of appendicitis have shown that the average risk of death on the planet is about 0.2-0.8%.
Europe and Asia
In the Greek lands in recent decades there has been a decrease in the incidence of inflammation of the appendix by 75% in comparison with the previously known standard. If earlier, one hundred thousand people were diagnosed with acute appendicitis in 652, this number changed to 164 patients on average. If in the period from 1970 to the end of the last century there were more women than men, the ratio was estimated at 1.27, then gradually this changed to the opposite state of male predominance. The mortality rate in Greece is stable, at least 0.09 deaths among hundreds of patients.
Spanish doctors found that in the millennium, there were 132 patients per hundred thousand men, and three years later, approximately 117.5 cases. Women are characterized by a more significant decrease in the incidence rate. The risk of perforation is estimated at 12.1%. Mortality after surgery is 0.38%.
In South Korea, the likelihood of acute appendicitis reaches 13.56 cases per 10 thousand people with a perforation risk of about 2.91. For this country, stability of average medical indicators is more characteristic.
What is it about?
In order for the statistics reflecting the frequency of deaths from appendicitis to change, it is necessary for the inhabitants to have a better, better understanding of the risks of this disease. Some suffer for hours from localized pain in the appendix area, others suffer such painful sensations for days, hoping that they themselves will disappear. If you start the process, peritonitis will begin - an inflammatory abdominal process, due to the thinning of the inflamed tissues and their destruction, in which the contents of the intestinal tract spreads through the cavity. At the time of rupture, the pain sharply becomes very strong, covers the abdomen completely, and the patient's condition becomes worse. The abdomen swells, the patient vomits, the discharge has the smell of feces, the patients burp.
You can suspect an aggravation of the case if the patient is motionless, the lips are especially dry, and the skin is pale. The thermometer shows a fever, observation of breathing - an increased frequency. The patient’s stomach is tense. If the condition is especially serious, delirium is possible. If such phenomena are observed, the decision of the doctors is one - an urgent operation. This approach is the gold standard of modern medicine. Timely surgery is a practically guaranteed guarantee of an early full recovery. True, it is impossible to remove the appendix in vain, without inflammation, since the organ is an element of the nervous system and is involved in the digestive tract. If, due to the inflammatory process, the appendix is no longer able to perform the functions prescribed by nature, organ removal is the most effective treatment option in modern conditions.
Disease start
As is clear from the above, inflammation of the appendix without proper treatment provokes a fatal outcome. In order to prevent this, you need to consult a doctor on time. Statistics show that it is the acute type that is the most characteristic and often observed reason for referring a person to a surgeon as urgently as possible. It is unlikely to be able to diagnose the disease on its own, therefore, at the slightest suspicion, you should immediately visit a doctor. Usually pains appear in the lower abdomen on the right side, but individual characteristics are possible. In addition to pain, patients are characterized by nausea. For some, it hurts first in the stomach, then the sensation shifts right down. Most recorded heat, chills. Observing such phenomena, you need to immediately call an ambulance.
The most difficult thing is to determine the disease in children - few are able to adequately explain the sensations. It happens that one zone hurts, and the patient calls another, it also happens that, because of the pain, the child does not let anyone in. In addition, you need to remember about the appendix: which side the person is on. Appendicitis appears more often on the right, but with an unusual arrangement, it can start in the left half of the body. It depends on the individual anatomical features.
Treatment: curious to know
Sometimes for health reasons, the inhabitants are forced to delve into what is called appendicitis.
On which side the person has the appendix, many know - usually on the right; No less widely known information about the possibility of atypical structure of internal organs. It is known that the only way to cure the disease is to go to surgery. It scares many people, I really want to get rid of the disease by drinking a miracle pill or several.
From the history of mankind it is known that for the first time they tried to treat appendicitis in the time of Avicenna. It was he who diagnosed the disease of the Bukhara ruler and removed the process. This is not known for certain, but some believe that the patient survived, although in those days they still did not know reliable antibiotics. For hundreds of years, scientists have tried to study appendicitis. Sometimes he was confused with muscle inflammation, uterine diseases. Attempts have been made to conservative treatment with gastric lavage, enemas and opium tinctures. As a result, the patient was dying, although not in such painful torment.
Operation: to do or not?
In the 19th century, doctors already knew whether it was possible to die from appendicitis, and learned to associate the symptoms of the disease and a specific organ. True, in 1839, when they had already compiled an official description of the disease, they still believed that the operation gave a dubious result. This was due to the lack of analgesics, antibiotics. For the first time, general anesthesia became available in 1846. From this moment, the operation turns into a less dangerous procedure. True, then the doctors did not yet know that it was necessary to remove the small process, so they opened the cavity, cleaned the pus from the fossa. In the 1880s, information appeared about the successful removal of inflamed areas.
In 1886, Fitz published a report by which the term "appendicitis" became generally accepted and spread. He gave a description of the clinical manifestations, and also recommended treatment with surgery. From this moment to this day, when diagnosing a disease, the optimal treatment option is surgery. Without surgery, the mortality rate was previously estimated at 67%. In our country, the first operation was performed by Troyanov in 1890 in St. Petersburg.
History and Medicine
For a long time it was believed that it was necessary to wait as long as possible, and to operate on the patient only in case of complications. In 1993, they finally determined the need for urgent hospitalization and removal of the inflamed organ before complications begin. In the 40s they began to use antibiotics, which made operations safer and more effective. True, this caused a rather long stage of unjustified operations for everyone. Up to 60% of organs removed were without signs of inflammation. Most often, young women were operated on. This increased the likelihood of adhesions in the peritoneum.
In the 60s of the twentieth century, laparoscopy, previously used only by gastroenterologists, became available. Gradually, we learned to use this method for diagnosing the condition, and for removing inflamed areas.
Diagnostics and operation
Previously, doctors, without reliable means of clarifying the condition, but knowing well whether it was possible to die from appendicitis, prescribed an operation to anyone and everyone who had signs of the disease. Over time, it became possible to use ultrasound to clarify the causes of abdominal pain. The problematic of this method is that the intestinal tract contains air, which is why the formations located especially deeply can “hide” from the doctor’s eye. They created sensors to solve this complexity. For a more accurate assessment of the condition, CT, MRI, and X-ray are shown. The diagnostic value of CT is 96%.
Today, work is underway to determine the tactics of treatment that allows the operation to be performed a month or more after the acute stage. Consider the possibility of conservative treatment with antibiotics. This is possible if the disease proceeds without complications, there are no risks to the patient's life. Today, like a century ago, doctors strive to exclude surgery if possible, however, such an expectation carries fewer risks than at the beginning of the last century.
Treatment: surgery or not?
In recent years, doctors are not only trying to convey to the general public whether it is possible to die from appendicitis, as well as the need for urgent and adequate treatment of inflammation associated with these risks, but also work towards finding new methods and approaches to combat the disease. Scientists annually publish scientific materials in European countries and the United States containing information about people who have had an emergency operation, as well as those who received antibiotic treatment. In 2012, information became known about 900 adults suffering from uncomplicated appendix inflammation. Of these, 430 received surgical treatment, 470 - conservative. Among the second category, 63% were completely cured, the rest still needed surgery. The probability of complications for the second group was estimated to be one third less than for those who were immediately referred for surgery.
In the same 2012, the results of the observation by Swedish doctors became known. The likelihood of relapse in antibiotic treatment in the annual perspective is estimated at 10-15%. About 80% of people whose condition allowed for conservative treatment were completely healed. Finnish researchers worked in 2015 with a group of 530 people. They were randomly assigned to treatment. 274 people received surgery, one died, 99.6% were successfully healed. Another 256 people were treated with antibiotics, observed by doctors for about a year. 72.7% were healed, 27.3% needed surgery. Complications against the background of late surgery were not recorded.
Children: to operate or not?
Doctors have long known about the danger of appendicitis: it can cause peritonitis. Inflammation is especially dangerous for children. The problem is also connected with the limitations in the possibility of organizing experiments: it is strictly forbidden to put them on children, especially in conditions of probability of death. An additional problem is that in children the course of any disease is often unpredictable. Given the danger of appendicitis (perforation of the inflamed area), the possibility of conservative treatment was analyzed. In 2017, a light saw the work, which reflected information on the use of antibiotics in 413 minor patients. The materials contained observations for a decade. The risk of relapse was rated at 14%. Recently, doctors dealing with the issue of whether it is necessary to remove appendicitis are considering the possibility of conducting additional studies on the use of antibiotics for sick children.
In general, it can be said that cure without surgery is possible. At the same time, this method cannot be considered massive. Given the possible complications after the operation to remove appendicitis, as well as the risks associated with the lack of timely operation, a number of conditions have been formulated that allow treatment with antibiotics. Conservative therapy is practiced only within the walls of the clinic. If there is no improvement, the patient is referred for surgery. Any complication threatens the life of the patient, so it is impossible to refuse operations.
About types
To adequately navigate the issue, you need to know what types of appendicitis are. Modern doctors distinguish acute and chronic course of the disease. It is customary to talk about the catarrhal type, phlegmonous, gangrenous, performative. The first is observed the first six hours of the disease. With it, the mucous membranes are affected, the organ swells. Phlegmonous stage is the spread of the inflammatory focus throughout the appendix as a whole. This stage develops after six hours and lasts the first day. The organ swells, pus is generated in the lumens.
Next, the gangrenous stage begins. At this stage, necrotic processes begin, inflammation covers the immediate zones of the peritoneum. The duration of the stage is about three days. The final step is performative. It is the people who have experienced it who will know what the consequences are if appendicitis burst. And they, admittedly, are the most severe, right up to death: peritonitis develops, since the contents of the inflamed organ penetrate into the abdominal cavity, initiates the inflammatory process. The likelihood of a successful cure, even when contacting the clinic at this stage, is relatively small.
About pain
Doctors know what kind of pain there is with appendicitis. The male half suffers from Horn's syndrome, that is, the soreness is sharp, severe, if you slightly press on the scrotum. The phenomenon of Britten accompanies a physical effect on the ileum. In this case, the testicle on the right pulls up and pain appears. Possible pain in the pubic area, genitals, if the anatomical placement of the diseased organ is non-standard.
In a woman, the pains resemble those characteristic of an ectopic conception. Typical soreness is called a symptom of Shchetkin-Blumberg. The needy is laid horizontally and pressed in front of the peritoneum, abruptly removing the force after a few seconds. There is pain.