Appendicitis

This name is the inflammatory process of the appendix of the cecum – the appendix. It is one of the most common surgical pathologies of the abdominal cavity. It is recorded mainly in children, as well as in men and women up to 30-35 years old. It proceeds in an acute or chronic form, the latter of which is much less common.

Symptoms of inflammation of appendicitis

The first manifestations of the acute form of the disease depend on the location of the appendix, the patient’s age, and the presence of concomitant diseases. The main symptom of organ damage is sudden abdominal pain. Depending on the individual structure of the body and the location of the appendix, it can be localized in the following areas:

around the navel;
in the epigastric region;
throughout the abdomen.

Pain can also be felt in the iliac region, right or left hypochondrium, in the lower back, in the external genitals. Its nature depends on the specific stage of the disease, of which there are several:

catarrhal – edema, disorder of blood and lymph circulation, the onset of purulent inflammation of the mucous membrane of the organ;
superficial – spread to the outer shell of the appendix;
phlegmonous – inflammation spreads to all layers of the appendix, small abscesses appear;
phlegmous-ulcerative – the picture is complemented by the appearance of multiple wounds on the mucous membrane;
gangrenous – the transition of a purulent process to the tissue.
The pain is not intense, but constant, aggravated by straining, moving, coughing, decreasing in the lying position on the right side. Additional symptoms of appendicitis are added:

nausea;
flatulence and constipation;
temperature increase;
increased heart rate;
coated tongue.

With the development of intoxication, vomiting, dryness of the tongue and mucous membranes join, constipation will be replaced by diarrhea, a slight decrease in blood pressure is added. If the pain has diminished or disappeared, you should be alert. This can be either a sign of a transition to the gangrenous stage, or a perforation of the appendix wall.

Causes of occurrence

The prerequisites for the development of purulent inflammation in the cecum are the penetration of infection into the organ. As a rule, these are local mixed microflora: strepto- and staphylococci, E. coli, enterococci, anaerobes, which enter the process from its lumen and multiply intensively. The reason is the impossibility of leaving the contents from the organ, which provoke:

bend of the appendix with its excessive length;
foreign body blockage;
the presence of excrement in its lumen;
helminthic invasion;
thick content;
proliferation of organ tissues.
The above factors lead to an increase in pressure inside the appendix, a decrease in mucosal resistance, which contributes to the multiplication of infection. The reasons for this are circumstances that reduce local and general immunity:

a diet with a high meat content and a lack of vegetables and fruits;
bad habits: smoking and alcohol abuse;
nervous tension and stress.
Another motive for the development of inflammation in the appendix is ​​a vasospasm of the organ’s vessels, which leads to impaired blood circulation in it. There is also a theory of the transition of inflammation from the ovaries to the cecum, which is nearby. According to Spanish scientists, in 45% of cases, the process is caused by such causes of appendicitis as chips and fried sunflower seeds.

Diagnosis of the disease

The diagnosis is made on the basis of the nature of the pain, as well as the results of palpation of the abdominal cavity, a blood test, in which a large number of white blood cells are determined, and a urine test with a high protein content. To confirm acute appendicitis, several instrumental methods are performed:

Ultrasound examination of the abdominal organs is a modern analogue of the X-ray. It is passed through the anterior abdominal wall, which requires a full bladder. Women may be examined vaginally to rule out reproductive diseases. A thickened wall of the appendix and too large a diameter indicates that inflammation is present. The accuracy is 50%.
A computer study gives a photograph of a section, and also allows you to examine the organ in detail in a monitor, in contrast to a conventional X-ray. If necessary, you can use a contrast agent to improve visibility. The accuracy of the method ranges from 80 to 85%.
Magnetic resonance imaging also uses a computer to scan an image, but it uses radio waves rather than X-rays. This sensitive method allows you to look inside the organ, as well as to make not only transverse, but also longitudinal sections. The accuracy of MRI is about 85%.

Which doctor should I go to?

How appendicitis manifests itself is indicated by the following symptoms: sudden sharp pain in the abdomen, radiating to the right side, which does not pass for a long time and intensifies with movement, fever, nausea and vomiting, constipation or diarrhea. In this case, you need to call an ambulance and take the patient to the surgical department, where he will be dealt with:

SURGEON

If an inflammation of the appendix is ​​suspected, the doctor must perform a number of actions to confirm the diagnosis:

listen to and analyze the patient’s complaints;
touch the corresponding areas of the abdominal region;
interview the patient to clarify the nature of the pain;
to measure the temperature;
carry out additional diagnostic methods: ultrasound, MRI, CT.
If none of them confirm the symptoms of appendicitis, the doctor will prescribe a laparoscopic diagnosis. In addition, the doctor will definitely refer the patient for general blood and urine tests. Consultation of additional specialists may be needed to rule out diseases with similar symptoms.

Possible complications

Timely treatment gives a favorable prognosis. However, if the patient has not sought medical help for a long time, acute appendicitis can give a number of complications:

breakthrough of the inflamed vermiform appendix;
intestinal obstruction;
pylephlebitis – vascular inflammation;
phlegmon of retroperitoneal tissue;
blood poisoning.

The most common consequence is perforation. It leads to an accumulation of infection or to infection of the entire abdominal cavity. Less common is the obstruction of a part of the intestine due to inflammation of the tissues near it. This causes symptoms such as vomiting and bloating due to the inability to pass gas. The most dangerous complication is sepsis – blood poisoning. Most often, it leads to the death of the patient, since the infection spreads through the bloodstream throughout the body, infecting all organs and systems.

Sometimes the precess spontaneously subsides, forming an inflammatory infiltrate, which is subsequently fraught with adhesions of the abdominal cavity. But most often this pathology progresses very quickly. On the sixth day, the complication becomes more and more extensive. Organs and tissues are drawn into it. It usually ends with the death of the patient.

Treatment

The pathology of the appendix does not lend itself to classical drug therapy at all. The only treatment is to remove it. The advantages of surgery are:

its simplicity;
efficiency;
no relapses.

The operation is carried out according to the results of the examination. Even if the process is not perforated, the doctor still prescribes its excision. Treatment includes several points:

antibiotic therapy that precedes surgery;
direct removal of the appendix;
postoperative period.

Antibiotics are used if the patient seeks help too late, when the process has developed perforation. In this case, such therapy is used before and after removal of the appendix until the temperature and leukocyte counts in the blood return to normal. In the event that the inflammatory process has captured the parts of the intestine, a resection of the entire formation is prescribed. In a pericolic abscess, the appendix is ​​first drained, monitored by ultrasound, and then removed.

How to treat appendicitis: only in the hospital!

If the first signs of inflammation of the appendix https://en.wikipedia.org/wiki/Appendicitis appear, do not try to be treated at home. With such a pathology, only an operation will help. Sometimes antibiotics are used to treat the inflamed appendix. However, if the process is caused by a foreign body or fecal stones entering the opening of the cecum, then after the drug is discontinued, the inflammation will begin with renewed vigor. In this case, only a scalpel can help. So, these and other myths of appendix treatment are:

antibacterial treatment;
folk methods: decoctions, infusions, teas, compresses;
removal of the appendix even before it becomes inflamed.

All of these judgments are fundamentally wrong. Alternative methods can only be used to eliminate pain or calm the nervous system. If you do not know what symptoms of appendicitis are, but you have a sharp pain in the abdomen and a deterioration in health, you should immediately call an ambulance to avoid complications. With inflammation of the appendix, only a doctor can help.