Appendicitis in surgical gastroenterology accounts for more than 80% of cases. The disease is more common in patients between the ages of twenty and forty years, but can occur in the elderly or children. Despite advances in diagnosis and the improvement of surgical methods, complications are 5–9%, and mortality 0.1–0.3%. But what happens if appendicitis bursts? In this case, the forecast is more serious.
Brief Description of the Disease
Inflammation of the appendix in the lower intestine is called appendicitis. In normal condition, it is a small tube 5-15 cm long and about 0.7-1 cm in diameter, which branches off from the cecum and gradually narrows without a passage.
The function of the appendix is not exactly known. Previously, the appendix was considered as a simple rudiment that a person left from descendants - distant ancestors with a plant diet. Today, there is substantial reason to believe that the appendix seriously affects the course of endocrine and immune processes, and regulates the intestinal microflora. People who have had appendicitis removed often have problems with an insufficient amount of their own beneficial microorganisms in their intestines.
As a rule, inflammation is acute. In the vermiform appendix, pus accumulates, the appendix increases and becomes painful. As a result, this leads to rupture of the wall and the release of pus outside. What will happen if appendicitis bursts? In most cases, this causes inflammation of the peritoneum - peritonitis.
The disease is fast and requires urgent medical attention. In the international classification (ICD-10) appendicitis is listed under the code K35. Acute appendicitis of unspecified nature - K35.9. Pathology belongs to the group K00-K92 (digestive organs diseases), the subgroup K35-K38 (diseases of the appendix). There are practically no cases of spontaneous cure. With timely treatment, the prognosis is usually favorable.
Causes of appendicitis inflammation
Why purulent appendicitis develops is not yet known exactly. Scientists agree that there is no single reason common to all patients. In each patient, the cause of inflammation is individual, but in most cases the acute form is provoked by a blockage of the entrance of the process into the rectum. This can happen due to the ingress of foreign bodies and feces into the channel, due to adhesions due to enteritis or cholecystitis.
A significant role in the occurrence of acute appendicitis and peritonitis is played by bacteria. As a rule, a combination of both factors takes place. Stagnation of the contents leads to a weakening of local immunity and the introduction of harmful bacteria into the mucosa. The scientific community is developing a theory according to which the main cause of appendicitis is vascular spasm. Other possible provoking factors are trauma to the abdomen, which caused the process to move.
Disorders of the stool, lack of plant fiber in the diet, frequent overeating, the presence of parasites, imbalance in the microflora, infectious diseases of the gastrointestinal tract, poor intestinal motility contribute to the disease. Perhaps influenced by hereditary factors, stress, a general decrease in immunity, a lack of vitamins and minerals in food. An increased incidence of the disease in pregnant women is noted. Doctors explain this by a displacement of the process caused by an increase in the size of the uterus.
How to recognize appendicitis
Symptoms of appendicitis are extremely important for early diagnosis. There is severe pain in the abdomen, affecting the area from the navel to the lower abdomen. Severe discomfort when walking and coughing may indicate inflammation of the abdominal wall. This is an extremely dangerous condition, which indicates that the appendix may soon burst or has already burst.
They do not necessarily indicate appendicitis and not in all cases, symptoms such as vomiting and nausea are manifested. People whose appendix is low enough may experience a complex of symptoms similar to cystitis. If you constantly want to go to the toilet, urinating is painful and accompanied by pain, then this can be a symptom of appendicitis. Common symptoms include fever, chills, general weakness, and lack of appetite. If confusion and disorientation are felt, then it is possible that the infection has entered the bloodstream.
Atypical forms of the disease
Purulent appendicitis in most cases manifests itself as a whole complex of symptoms that make the patient urgently seek medical help. But sometimes doctors are faced with atypical forms of the disease. In this case, signs of inflammation can be very weak or even absent. With empyema, for example, pain appears in the iliac region, and retroceremental appendicitis is characterized only by loose stools and slight discomfort in the lumbar region. In this case, the patient may not know that his appendicitis has burst. The consequences can be very serious (up to death).
What to do if you suspect appendicitis
If appendicitis is suspected, a doctor should be called. A sufficient basis is any abdominal pain that does not go away within six hours. Before the examination, antibiotics, laxatives, analgesics and other medications should not be taken, as this can smear the clinical picture. As a result, an incorrect diagnosis will be made, and time will be lost. It is forbidden to put a heating pad on the stomach, because heat can accelerate the spread of the disease. The doctor needs to report all symptoms and allow an examination.
Rupture of the appendix: consequences
Timely recognition of symptoms of appendicitis, seeking medical help and early surgical intervention are the key to a favorable outcome. But what happens if appendicitis bursts? If you hesitate, the inflamed process will burst, and pus and feces will fall into the abdominal cavity. This will cause inflammation - peritonitis.
The clinical picture of peritonitis is developing rapidly. In the absence of therapy, only 2-3 days can pass from the onset of inflammation to the death of the patient. Therefore, a patient experiencing severe abdominal pain that does not go away after taking antispasmodic drugs, you must immediately consult a doctor. The crucial factor in rescuing the patient is usually the timely emergency call.
Appendicitis can provoke sepsis, abscesses in the abdominal cavity, and pylephlebitis. The last condition is especially dangerous. Earlier purulent thrombophlebitis of the portal vein was fatal in 90% of cases, but with the advent of diagnostic methods such as computed tomography and MRI, mortality was reduced to 40%. When surgery to remove appendicitis, doctors always carefully examine the vessels in order to detect thrombosis in a timely manner.
Differential diagnosis
Diagnosis is based on examination of the patient and palpation. The main symptoms are tension, pain in the right side of the abdomen (below). But these traditional methods are not always reliable. During the diagnosis, ultrasound, CT, MRI, urine and blood tests are often used. When evaluating the results of a blood test, attention is paid to increasing the content of white blood cells. To clarify the diagnosis, a diagnostic examination can be performed through an opening in the peritoneal wall (laparoscopy).
The recognition of the disease is complicated by the fact that the signs of acute appendicitis are in many ways similar to the symptoms of other gastrointestinal diseases. Appendicitis can be confused with renal colic, ulcer, gastroenteritis, inflammatory process of the uterus, rupture or stretching of the abdominal muscles. These conditions in most cases do not require urgent surgical intervention.
Appendix removal operation
The main way to treat acute appendicitis is surgery. In some cases, antibiotic therapy precedes surgery. Conservative treatment is possible only in some rare cases, but it is categorically impossible if appendicitis has already burst. As a rule, they resort to medication if there are serious contraindications to the operation.
The operation to remove the appendix is performed either in the traditional way or by the laparoscopic method. The first twelve hours after the intervention, it is recommended to observe bed rest and avoid eating. The rehabilitation period depends on at what stage the disease was detected. Typically, the patient can return to normal life (with minor restrictions) in just one to two weeks.
Prognosis for acute appendicitis
What will happen if appendicitis bursts? This condition threatens the life of the patient and requires urgent medical attention. In case of complications, a fatal outcome is possible. The patient’s death can be caused by the rapid development of adhesive intestinal obstruction, local abscesses in the peritoneum, accumulation of appendicular infiltrate and other acute conditions.