This disease is an inflammation of the appendix appendix (cecum). It is quite common in our country. And it is considered the most common disease of the abdominal cavity. Often requires urgent surgical intervention. With the launched form or prescription for more than two days, the appendix may burst. In this case, death occurs . Therefore, it is very important to diagnose it in a timely manner and carry out the operation.
Appendicitis: symptoms, causes of the disease
So why is it escalating? We will analyze how appendicitis appears. The causes of the occurrence today are still not exactly established. It is difficult to say why the inflammation begins. But studies of the disease show that its development requires two conditions. The first is the presence of the necessary bacteria in the intestine, the second is the blockage of the lumen of the process with feces, seeds or various seeds. Sometimes foreign bodies are found in the appendix, for example, small parts from toys.
The disease begins with pain, but it is usually not possible to independently determine its clear location. It seems to a person that his stomach just hurt, but after five hours the pain begins to concentrate in the iliac right region of the body. The appendix in general can be located in different ways, it depends on the individual structure of the body.
In the normal position of the appendix, pain is observed in the right region. If the appendix is slightly higher, then it appears under the ribs on the right. If the process is located below, then the pain will be observed in the pelvic region. In addition, vomiting and sometimes even diarrhea can begin.
There are other symptoms by which exacerbation can be determined: dark urine, dry mouth (mainly the tongue), temperature rises (often up to 40 degrees). During pregnancy, when a woman is in a supine position, she develops pain when turning the body from left to right side.
Diagnostics
The reasons for the appearance of appendicitis are still not clear, and to determine them is not so easy. Symptoms vary depending on the location of the inflamed process. Diagnosis is based on blood tests (much more white blood cells appear in it) and urine (the amount of protein increases). X-rays are carried out quite rarely, since it does not determine the exact diagnosis. Thanks to the image, only fecal stone is detected, which clogged the opening of the process.
Ultrasound is also done to determine acute appendicitis. Sometimes - tomography on a computer. With its help, an image of the vermiform appendix is enlarged. At the same time, intestinal tissues that have changed are clearly visible.
Complications
One of the most common complications is perforation. It can lead to periappendicular abscess (accumulation of infected pus) or to diffuse peritonitis (this causes infection of the entire abdominal cavity). Causes of acute appendicitis inflammation : improper diagnosis and delay in treatment.
Intestinal obstruction is much less common. It can occur if inflammation around the process stops the intestinal muscles from working, which prevents the passage of feces through it. The abdomen swells and vomiting and nausea occur. The part of the intestine, which is located above the place where the patency is impaired, is filled with gas and liquid.
But the most important and dangerous complication is blood poisoning (otherwise - sepsis). This is a painful condition when bacteria enter the bloodstream and spread throughout the body. Complications can even be fatal.
Treatment
How is appendicitis treated? The reasons for its occurrence can be very different. For example, exacerbation sometimes occurs with complications of diseases of the intestine or stomach. But just eating sunflower seeds with husks can also lead to appendicitis. If it is precisely established that it has manifested itself, then, so that there are no adverse side effects, you should not take any laxatives or painkillers, and even more so, apply heating pads. It is best to put in a place that hurts something cool and immediately call an ambulance. If appendicitis is confirmed, then the process is removed using one of four methods: typical, retrograde, laparoscopic and transluminal.
Postoperative period
With a simple form of the ongoing disease, the patient, even on the first day after the operation, may begin to roll over on the bed, on the second - to sit down, on the third or fourth - to get up. You can take food only from the 3rd day, and it should be liquid or porridge. Already from the sixth day they usually switch to diet food.
Children's appendicitis
In the first years of life, it is extremely rare. It mainly occurs after 7 years. And the initial sign may be abdominal pain. This does not say exactly about this disease, since this symptom can occur for other reasons. However, it is still necessary to visit a doctor to check. Why can appendicitis still occur? The reasons for its occurrence may lie in the slagging of the gastrointestinal tract or infection in the body.
This inflammation can be chronic or acute. The latter form in children is most often diagnosed. In this case, the child's pain appears suddenly, nausea and even vomiting begin immediately. After a few hours, the pain moves down the abdomen and begins to pulsate near the cecum. When you cough or try to lie on your left side, it intensifies. In this case, it begins to dry in the mouth, constipation or diarrhea may appear.
With young children under 7 years old, you need to be very careful with such symptoms, since it is generally quite difficult to determine appendicitis. Because they simply cannot tell where and what exactly hurts.
Causes of appendicitis in adolescents and children. Why does it arise?
In adolescence, the disease is very common. Most exacerbation occurs in spring or autumn. Causes of appendicitis in children and adolescents: in most cases, the disease occurs due to a decrease in immunity. As a result, the body is not able to withstand viruses and bacteria, an infection provokes inflammation in the appendix.
Other causes of appendicitis in children: it can cause an altered diet and a violation of the functions of the stomach. Often a large role is played by the inattentive use of seeds, nuts, berries. Children often swallow husks, shells, small bones, so parents should carefully monitor them. Also, ordinary worms can provoke the disease.
Since the children's body is not yet fully formed, it is quite difficult to make an accurate diagnosis. In a child, the development of the disease is much faster than in an adult. Children become lethargic, there is a sharp decrease in appetite, chills, nausea, constipation and acute abdominal pain. The temperature can rise to 40 degrees.
In adults
Many cases of exacerbation occur between the ages of 20 and 30 years. Often appendicitis occurs in pregnant women who are predisposed to diseases of the intestinal tract and suffering from constipation. Although the pathology is not dependent on gender. Who has appendicitis more often? The reasons for it are approximately the same at any age. However, in children, the appendix is underdeveloped and easily emptied, and in adults, on the contrary. Consequently, the latter suffer from this disease more.
Causes of appendicitis in adults: it can be any bowel disease, abdominal injury, inflammation of the digestive tract or helminth infestations. In addition, doctors believe that the cause may be the abuse of protein foods.
Acute form
What triggers acute appendicitis? The causes of this form: the first is a blockage of the process, the second is the entry of staphylococci, Escherichia coli, streptococci and enterococci into it. They are interconnected, since in both cases ideal conditions are created for the rapid multiplication of bacteria. In the first case, everything leads to stagnation of the contents and inflammation of the walls of the appendix, and in the second case, an inflection of the intestine and the inability to empty are provoked.
In the West, doctors have identified a separate cause of exacerbation - when fusobacteria, which cause necrotization in its tissues, enter the process. The infection develops rapidly and causes purulent and inflammatory processes. Conservative treatment is common in the West, but in Russia it is rarely used.
Other causes of acute appendicitis: yersiniosis, typhoid fever, tuberculosis, amoebiasis, etc. In addition, the process is facilitated by the excessive formation of proteins in the body, it leads to their rapid breakdown in the intestines and the beginning of the rotting process. They also identify as a separate reason the tendency to constipation, as a result of which timely emptying of the intestine does not occur, and conditions are created for the rapid multiplication of bacteria.
Chronic appendicitis
In adults, it is recorded quite rarely, no more than one percent for all cases of appendicitis. A person experiences periodic pain, aggravated by walking and coughing. With relapse, the symptoms are the same as with acute appendicitis. In this case, body temperature is normal or subfebrile. Often such appendicitis is classified as pyelonephritis, peptic ulcer, chronic abdominal disease.
Purulent appendix
This is an inflammation of the appendix, which combines several types of acute disease. Why does purulent appendicitis occur? The reasons may be the following: an abundance of lymph, poor blood supply, the presence of a convoluted narrow lumen, and variability of location. In this case, microbes penetrate into the process by hematogenous, lymphogenous, or (most often) enterogenous means. With this type of inflammation, the flora is polymicrobial.
Stages of the disease
There are several periods:
- Catarrhal appendicitis (first 12 hours). Typical symptoms are discomfort and pain in the stomach, most often in the evening and at night. Similarity to signs of gastritis. During this period, weakness, malaise is observed, but the abdomen remains soft, despite the pain when pressing on it to the right.
- Phlegmonous appendicitis (at the end of the first day). The pain is clearly localized on the right, in the iliac region. It is throbbing and quite intense. There is nausea, tachycardia, fever. The abdomen in the area of the inflamed process is tense.
- Gangrenous appendicitis (second and third days). The process ends die off, general intoxication in the body increases, tachycardia is pronounced. The temperature drops sharply, the stomach swells, there is a lack of peristalsis.
- Perforated appendicitis (at the end of the third day). Acute and severe pain in the right lower abdomen, its intensive growth. The absence of periods of relief, the stomach is swollen and tense, constant vomiting begins. Plaque on the tongue instead of white becomes brown. The temperature rises to a critical point. The outcome is purulent appendicitis or local ulcer.
Diagnostic difficulties
Why is it sometimes difficult to diagnose appendicitis? Doctors still find it difficult to name the reasons for its occurrence for sure. The position of the appendix is different. More often it is located in the lower abdomen - in the right area, but may have a mesentery. This is a film, similar to a sheet, attaching the process to structures that are in the abdominal cavity. With a long mesentery, the appendix sometimes noticeably shifts. In addition, it can sometimes be longer than usual.
In some cases, the appendix descends into the pelvic region, and in women it is located between its joints. It can also be located behind the colon. In such cases, the symptoms are similar to inflammation of various organs (e.g., pelvic).
It is difficult to determine appendicitis in those situations when a person has other inflammatory processes that can give similar symptoms. Therefore, initially the patient is observed for some time in order to accurately diagnose, since signs of appendicitis can manifest themselves more typically after some time.