Today, the frequency of visits to doctors with complaints of problems with the gastrointestinal tract is only increasing. One of the most common diseases is inflammation and rupture of the appendix. It is especially dangerous when this happens, and there is no timely surgical intervention. In such cases, everything can end in death.
What happens in the body?
The inflammatory process lasts about 3 days, during which catarrhal and purulent (sometimes gangrenous) changes occur. If no operation is performed within this time, a rupture occurs.
The main symptom is a feeling that something inside has spread, warmth is felt in the abdomen. The most severe consequence is diffuse peritonitis, which can be fatal.
A person is not immune from such a problem at any age.
In what situations can a breakup occur?
The main cause of appendicitis rupture is a structural feature of the patient's gastrointestinal tract, for example, the presence of a kink in the process.
To othersreasons include:
- closing of the process of the caecum with feces and/or stones;
- getting into the appendix of a foreign body;
- bacterial infections;
- malignant and benign neoplasms;
- mechanical and other injuries of the abdominal cavity.
Not last but not least is malnutrition, as a result of which toxic and harmful substances accumulate in the appendix.
Symptomatics
At the initial stage of the development of the disease, pain appears in the navel, which slowly passes into the lower abdomen on the right side.
Other symptoms of a ruptured appendix include:
- increase in body temperature (up to 40 degrees);
- nausea, often turning into vomiting;
- feeling chilly;
- diarrhea, false urge to defecate;
- feeling of trembling in limbs.
Pain in the lumbar region may appear. The pain in the abdomen gets worse and then disappears. This happens against the background of the fact that the nerve endings are temporarily paralyzed. Most likely, the symptoms of intoxication will be pronounced.
Diagnostic measures
Despite the fact that the signs of appendicitis rupture are always quite pronounced, in any case they can be symptoms of another disease. First of all, a blood test is performed, which will show the number of leukocytes, their increase speaks in favor of the fact that there are problems with the appendix.
Diagnostic measures are designed to exclude the possibility of gastritis, pyelonephritis, urolithiasis, intestinal obstruction and a number of other pathologies.
Features of symptoms and diagnosis in women
In addition to common symptoms, in women, pain can radiate to the left side. They are aggravated by laughing or coughing.
A characteristic symptom of ruptured appendicitis in pregnant women is very severe shortness of breath. At such moments, the main thing is not to confuse pain from appendicitis with labor pains. There may also be hardening of the abdomen, due to the fact that its walls are overstressed.
For women is also characterized by a lack of appetite during this period. Often there is a general weakness. Typically, symptoms appear in the late afternoon and progress as night falls.
After the fourth month of pregnancy, the diagnosis of ruptured appendicitis presents a challenge. During this period, the uterus increases in size, the appendix moves closer to the liver. Therefore, it is very difficult to distinguish inflammation of the biliary tract from appendicitis. An effective diagnostic technique is considered to be an ultrasound or MRI, as a last resort, X-ray.
Peculiarities of diagnosis in children
It is enough to simply confuse the symptoms of poisoning and inflammation of appendicitis, especially when it comes to a child under the age of 3 years. He is not yet able to clearly explain what he has and where it hurts. By the way, appendicitis is the fourth in the list of incorrectly established diagnoses in childhood. The child's symptoms andadult is the same. A gap in almost 50% of cases occurs due to late diagnosis. As a rule, the disease is best diagnosed by ultrasound, with this method there are only 5% errors.
According to statistics, in the postoperative period in 5% of cases in children there is intestinal obstruction. Data on the appearance of an abscess is also disappointing, it is observed in 15-20% of babies.
In light of this, never ignore your child's abnormal behavior. Especially if he complains of pain in the abdomen during the day, and he has diarrhea. Has the child lost his appetite, cannot run and jump because of pain, does not even want to walk? All these symptoms can confirm the presence of an inflammatory process in the appendix, so they should not be ignored.
You can make a diagnosis at home before the arrival of the ambulance. The child is placed on his back, and he must bend his knees. After that, you should press your finger on the abdomen on the right side and quickly release. If the pain intensified, then it is almost 100% that these are problems with the appendix.
First Aid
How long can appendicitis hurt before it ruptures? Approximately for 1-3 days. It is possible to diagnose inflammation of the appendix already for 10-12 hours from the moment the attack began. If measures are not taken at this moment, then in a day or two its walls are torn, after which all the contents are thrown into the abdominal cavity.
When the first signs appearyou should immediately call an ambulance and limit the mobility of the patient. You can’t eat at this moment, you can only drink clean water in a small amount. In no case should you take medications and warm the area of \u200b\u200bthe appendix. In extreme cases, you can do a cold compress. With this pathology, no folk remedies will help, only surgery is an effective solution to the problem and eliminates the risk of complications.
Timely surgical operation is the key to a decent quality of life in the future.
Possible consequences
Rupture of the appendix can lead to two kinds of complications. The most harmless is the appearance of abscesses (abscesses) near the process and in nearby tissues.
The worst outcome is inflammation of the abdominal cavity (peritonitis), followed by sepsis and death. Peritonitis causes a number of diseases that lead to the death of the patient. It may be pylephlebitis, that is, inflammation of the hepatic vein. The disease is very transient.
Peritonitis can also cause meningitis. In this case, the bacteria enter the bloodstream, instantly spread throughout the body and form metastatic foci. In addition to the brain, microbes can get into the outer shell of the heart muscle, then endocarditis appears. The penetration of bacteria into the bone tissue leads to the appearance of osteomyelitis.
It is not excluded the occurrence of thrombophlebitis or appendicular infiltrate, that is, soldering of tissues in the large or small intestine.
Treatment of ruptured appendicitis
What are the methods of treatment of this pathology called? There are two methods that surgeons use:
- Public method. The operation takes 60 minutes. An incision is made from 4 to 15 centimeters, and the process is removed.
- Laparoscopic technique. In this case, four small incisions are made, the camera is inserted through one, and the instruments through the other three.
Depending on the degree of damage to the abdominal cavity, pus removal and drainage may be performed.
Rehabilitation period
After the appendicitis has ruptured and a surgical operation has been performed, it is allowed to resume motor activity only on the second day. You will have to follow a strict diet, which allows the use of kefir, a rosehip drink and tea.
In the next five days, pureed soups and potatoes, cereals are gradually introduced, during this time the motility of the stomach should be fully restored. If there are no complications, then after this time you can return to your normal diet.
Along with the diet, the patient will need to take antibacterial and pain medications. Detoxification therapy is also carried out. In the period from the 4th to the 6th day from the moment of the operation, the stitches are removed.
Failure to follow the recommended postoperative rules may lead to inguinal hernia oradhesive disease.
