This disease is an inflammation of the process of the appendix (caecum). 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 a running 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 perform an operation.
Appendicitis: symptoms, causes of the disease
So why is it escalating? Let's look at how appendicitis appears. The causes of occurrence today have not yet been precisely established. It is difficult to say for what reason inflammation begins. But studies of the disease show that two conditions are necessary for its development. The first is the presence of the necessary bacteria in the intestines, the second is the blockage of the lumen of the process with feces, seeds or various bones. Sometimes foreign bodies are found in the appendix, such as small parts from toys.
The disease begins with pain, but it is usually impossible to determine its clear location on your own. It seems to a person that he just had a stomach ache, but after fivehours, 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 process, pain is observed in the right area. If the appendix is a little 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 may begin.
There are other symptoms by which an exacerbation can be identified: dark urine, dry mouth (mainly tongue), fever (often up to 40 degrees). During pregnancy, when a woman is in a supine position, she has pain when turning her body from left to right side.
Diagnosis
The causes of appendicitis are still unclear, and it is not so easy to determine them. 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 performed quite rarely, as it does not determine the exact diagnosis. Thanks to the picture, only a fecal stone is revealed that clogged the opening of the process.
An ultrasound is additionally done to determine acute appendicitis. Sometimes - tomography on a computer. With its help, an enlarged image of the appendix is obtained. At the same time, intestinal tissues that have changed are also clearly visible.
Complications
One of the most common complications is perforation. It can lead to a periappendicular abscess (a collection of infected pus) or diffuse peritonitis (infection of the entire abdominal cavity). Causes of inflammation of appendicitis in acute form: incorrect diagnosis and delay in treatment.
Intestinal obstruction is much rarer. It can occur if the inflammation around the appendix stops the muscles of the intestine from working, which prevents the passage of feces through it. The abdomen swells and vomiting and nausea occur. The part of the intestine that 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 (in other words, sepsis). This is a painful condition when bacteria enter the bloodstream and spread throughout the body. A complication can even lead to death.
Treatment
How is appendicitis treated? The reasons for its occurrence can be very different. For example, an exacerbation sometimes appears with a complication of diseases of the intestines or stomach. But just eating seeds with husks can also lead to appendicitis. If it is precisely established that it has manifested itself, then in order to avoid adverse side effects, you should not take any laxatives or painkillers, and even more so apply heating pads. It is best to put something cool on the place that hurts and immediately call an ambulance. If appendicitis is confirmed, then the appendix is removed using one of four methods: typical, retrograde,laparoscopic and transluminal.
Post-operative period
With a simple form of a flowing disease, the patient, even on the first day after the operation, can begin to gradually turn over in bed, sit down on the second, and get up on the third or fourth. You can take food only from the 3rd day, and it should be liquid or mushy. Already from the sixth day they usually switch to diet food.
Children's appendicitis
In the first years of life, it is extremely rare. Mostly occurs after 7 years. And the initial symptom may be pain in the abdomen. This does not speak specifically about this disease, since this symptom can occur for other reasons. However, it is still necessary to visit a doctor for verification. Why else can appendicitis occur? The reasons for its appearance 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 diagnosed most often. In this case, the child's pain appears suddenly, nausea and even vomiting immediately begin. After a few hours, the pain moves down the abdomen and begins to throb near the caecum. When coughing or trying to lie down on the left side, it intensifies. At the same time, the mouth begins to dry, 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. becausethey simply cannot tell where and what exactly hurts.
Causes of appendicitis in adolescents and children. Why does it occur?
In adolescence, the disease is very common. Mostly 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 resist viruses and bacteria, an infection that provokes inflammation gets into the appendix.
Other causes of appendicitis in children: it can be caused by a changed diet and a violation of the functions of the stomach. Often the inattentive use of seeds, nuts, and berries plays an important role. Children often swallow husks, shells, small bones, so parents should carefully monitor them. Even ordinary worms can also provoke a disease.
Since the child's body is not yet fully formed, it can be 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 pain in the abdomen. The temperature can rise to 40 degrees.
Adults
Many flare-ups occur between the ages of 20 and 30. Often appendicitis occurs in pregnant women with a predisposition to diseases of the intestinal tract and suffering from constipation. Although the pathology does not depend on gender. Who is more likely to get appendicitis? The reasons for it are about the same in anyage. However, in children, the process is underdeveloped and is easily emptied, while in adults it is vice versa. Consequently, the latter suffer more from this disease.
Causes of appendicitis in adults: it can be any bowel disease, abdominal trauma, inflammation of the digestive tract or helminthic infestations. In addition, doctors believe that the cause may be the abuse of protein foods.
Sharp shape
What causes acute appendicitis? The reasons for the emergence of this form: the first - blockage of the process, the second - the ingress of staphylococci, E. coli, streptococci and enterococci into it. They are interrelated, since in both cases ideal conditions are created for the rapid reproduction 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, the occurrence of an inflection of the intestine and the impossibility of emptying is provoked.
In the West, doctors have identified a separate cause of exacerbation - when fusobacteria enter the process, which cause necrosis in its tissues. The infection develops rapidly and causes purulent and inflammatory processes. In the West, conservative treatment is common, but in Russia it is used quite rarely.
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, which leads to their rapid breakdown in the intestines and the onset of the process of putrefaction. Also distinguished as a separate cause is a tendency to constipation, inas a result of which there is no timely emptying of the intestines, and conditions are created for the rapid reproduction 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, the body temperature is normal or subfebrile. Often such appendicitis is classified as pyelonephritis, peptic ulcer, chronic disease of the abdominal cavity.
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 as follows: an abundance of lymph, poor blood supply, the presence of a tortuous narrow lumen, variability in location. In this case, microbes penetrate into the process by hematogenous, lymphogenous or (most often) enterogenous way. With this type of inflammation, the flora is polymicrobial.
Stages of disease
Separate 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 with signs of gastritis. During this period, there is weakness, malaise, but the abdomen remains soft, despite pain when pressing on it on the right.
- Phlegmonous appendicitis (at the end of the first day). The pain is clearly localized on the right, in the iliac region. She's pulsating andpretty intense. There is nausea, tachycardia, fever. The abdomen in the area of the inflamed process is tense.
- Gangrenous appendicitis (second and third days). There is a death of the endings of the process, the general intoxication in the body increases, tachycardia is pronounced. The temperature drops sharply, the abdomen 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 intense increase. The absence of periods of relief, the stomach is swollen and tense, constant vomiting begins. The coating on the tongue turns brown instead of white. The temperature rises to a critical point. Outcome - purulent appendicitis or local abscess.
Diagnostic difficulties
Why is it sometimes difficult to diagnose appendicitis? The reasons for its occurrence, doctors still find it difficult to name exactly. The position of the shoot is different. More often it is located in the lower abdomen - in the right region, but may have a mesentery. This is a sheet-like film that attaches the process to the structures that are in the abdominal cavity. With a long mesentery, the process sometimes shifts noticeably. In addition, it can sometimes be longer than usual.
In some cases, the appendix descends into the pelvis, 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 (eg, pelvic organs).
It is difficult to determine appendicitis in situations where a person has other inflammatoryprocesses that can give similar symptoms. Therefore, initially the patient is observed for some time in order to accurately diagnose, since the signs of appendicitis may appear more characteristic after a while.
