Adhesions after appendicitis are compacted connective tissue, which is localized both in the intestine and in nearby organs. A pathological change like this occurs due to surgical errors during surgery or due to non-compliance by the patient with the doctor's instructions.
What are spikes
What does the statistics say? 90% of patients develop adhesions after appendicitis. Outwardly, they resemble a thin film or look like a dense fibrous strip. The fabric, which has the shape of a rope, is what “adhesions” are. Its main function is connective. "Fibers" are formed after the operation. Seals are sometimes diagnosed in the peritoneum.
Given that after the removal of the appendix, the internal organs were subjected to mechanical stress, seals form on the intestinal membranes, which grow, increasing in volume. The following description gives a clear idea of ​​what adhesions are: the peritoneal membrane grows to the site of inflammation, preventing the spread of the neoplasm, but another problem arises - the blood vessels are affected. The intestine is deformed, its loops can grow together.
In accordance with the classification of diseases according to ICD-10, the appendicitis code is assigned to number XI. Variants of acute appendicitis are assigned values ​​of the type K35 according to the nature of the course of typical diseases.
ICD-10 code of appendicitis:
- acute appendicitis - K35;
- with diffuse peritonitis - K35.2;
- with local peritonitis - K35.3;
- unspecified (without specifying the type of peritonitis) - K35.8;
- chronic, recurrent and other forms - K36;
- unspecified - K37.
Reasons for the formation of adhesions
Surgery to remove appendicitis is the most common. In the absence of complications, the patient's recovery period is about two weeks. But with the first symptoms of adhesions after removal of appendicitis, it is necessary to begin treatment. Successful therapy will prevent pathological tissue changes.
The most common causes of adhesions after appendicitis are removed:
- untimely detection of appendicitis, as a result of which tissues are damaged by microorganisms, toxins;
- heredity - a certain percentage of patients suffer from adhesions after appendicitis, regardless of compliance with preventive measures;
- violation of the technical conditions of the operation;
- the presence of foreign substances in the wound after surgery;
- circulatory disorders in the tissues;
- the appearance of bleeding during surgery;
- non-compliance with the diet and irritation of the layers covering the organs;
- lack of physical activity after surgery.
Seals are formed within a few days after surgery. For this reason, bowel function suffers. Thus, symptoms of adhesions after appendicitis are manifested.
Symptoms
If pathological changes are minor, symptoms are absent, in whole or in part. A postoperative scar or the inside of the peritoneum can hurt, more often after physical exertion.
The main symptoms of adhesions after appendicitis:
- pain in the lower abdomen reminds of itself, which can intensify with changing weather conditions, occur during physical exertion;
- weight loss is observed;
- decreased appetite makes itself felt;
- digestion is broken, belching and heartburn appear;
- with a prolonged course of the disease causes constipation discomfort;
- intense gas evolution is observed;
- there is a risk of intestinal obstruction.
Intestinal obstruction is complicated by increased pain, fever, unpleasant symptoms of intoxication, including vomiting with fecal particles. In addition to this, the activity of the cardiovascular system is disrupted, blood pressure decreases, drowsiness is present, and working capacity decreases.
Danger of complications
Disruption of intestinal activity leads to a deficiency of essential trace elements in the body and poor metabolism. The main complications arising from the background of adhesive disease:
- intestinal necrosis occurs due to impaired blood flow and clamping of the arteries, tissue necrosis occurs, therefore, removal of the affected organs is required;
- acute intestinal obstruction develops due to the fact that adhesions squeeze the intestinal tube;
- problems with conception in women are not excluded.
Symptoms are quite pronounced only with an acute form of pathology. Signs appear when there is a threat to the patient's life. In case of acute intestinal obstruction, as the vomiting reflex often indicates, an ambulance must be called.
How adhesions after appendicitis hurt:
- severe pain is felt;
- frequent constipation;
- disturbs noticeable bloating;
- possibly a prolonged lack of stool;
- pain on palpation of the intestinal zone is expressed.
The listed signs indicate complications in which there may be a need for reoperation. With a chronic form of deviation, body weight decreases. If the inflammation passes into the area of ​​the appendages, this prevents the conception in the female body: a menstrual cycle and an ectopic pregnancy are possible.
Diagnostics
Diagnosis is necessary to confirm the presence of adhesions. The patient receives a referral for the following types of examinations:
- general and biochemical blood analysis;
- Ultrasound
- radiography using a tinted substance (will show a picture of defects);
- diagnostic laparoscopy (introduction into the device with a camera and lighting).
Test results confirm the presence of inflammation. Despite the severe symptoms, it is forbidden to take painkillers, as this will complicate the diagnosis.
Treatment
Therapeutic methods are selected taking into account the severity of the disease. How to treat adhesions after appendicitis:
- At the initial stage, conservative therapy is indicated. As prescribed by the doctor, the patient receives an individual prescription for taking medication. Aloe, folic acid, vitamin E are prescribed, thanks to which adhesive cords become more flexible.
- Physiotherapy - carry out paraffin applications, electrophoresis using magnesium, zinc, novocaine.
- With an advanced degree of deviation, surgical intervention is recommended - the adhesion cords pressing on the inside are cut off with a laser or an electric knife. Before the operation, the patient observes fractional nutrition, and then applies a cleansing enema.
Laparoscopy is indicated for older people, if there are problems with the cardiovascular system, conservative treatment is recommended.
Deviation Prevention
The risk of developing adhesions cannot be completely excluded, but all measures can be taken to prevent them. Preventive measures are to avoid food poisoning, to comply with all recommendations prescribed after surgery.
Methods that reduce the likelihood of adhesions:
- The endoscopic method of surgical intervention - the intestine is exposed to a minimal degree of exposure, the risk of infection is low, the sutures are quickly tightened. The method of operation is determined by a specialist based on a number of indicators.
- Also, the patient is prescribed medications that neutralize the action of fibrin, which accumulates in the areas of adhesion formation (Streptokinases, Trypsin, Fibrinolysin, antibiotics).
- To eliminate inflammation, antibacterial agents are used.
How to avoid adhesions after appendicitis:
- After surgery, it is necessary to ensure light physical activity (perform coups from side to side on the bed, on the second or third day you should walk around the ward).
- Eliminate excessive muscle tension after surgery.
- Follow the doctor’s instructions regarding medication and nutrition.
Postoperative period
After the operation, the patient should be monitored. In the first five hours, with the successful operation of appendicitis, the doctor allows you to stand up. You can drink water, food is prohibited on the first day. In difficult cases, the patient may be in a supine position for one day or two. In the future, the vertical position of the body and simple movements will help him rehabilitate.
In the post-ambulatory period at home, the patient should devote time to light gymnastics. The intensity of the load is determined by the doctor. The muscles of the press can be used only a month after removing the stitches, and running and active games should be postponed for a period of about three months.
Bans and recommendations:
- Hiking at a distance of about two kilometers is useful.
- Seams cannot be wetted. Full bathing is allowed after two weeks, if there are no complications.
- Within a month after the healing of the joints, alcohol is prohibited.
- Smoking is prohibited for at least three days.
- Full sex is permissible no earlier than a month later. Unstressed sexual intercourse - in a week.
- It is not recommended to go on vacation during which bathing is planned, since suppuration of the sutures is not excluded. Sunbathing is permitted in moderation.
Nutrition rules
In the first days after surgery, the patient’s diet includes broths, steamed dishes, cereals on the water, fruit jelly, kefir, mashed squash and pumpkin. Products should not promote active gastric acid secretion.
The patient is prescribed daily intake of vitamin E and foods containing calcium. Careful attention to the exact diet is required. It is not permissible to starve or overeat. The food should be warm, not causing spasms, its entry into the body should occur in small portions. A large volume of drinking is shown in the form of juices, compotes, herbal decoctions.
The following products are prohibited in the first month after surgery:
- gas-forming: cabbage, legumes, radishes, corn;
- fatty, smoked dishes;
- dairy products with a high percentage of fat content;
- spicy, sweet and salty;
- butter and flour;
- drinks containing a percentage of alcohol;
- tea and coffee.
Every day, the diet can be supplemented with a new dish, but gradually and taking into account the doctor's prescriptions. Having overcome the period of risks, the former patient will be able to return to his usual lifestyle.