Appendicitis is the most common gastroenterological disease. Inflammation usually occurs suddenly. Manifestations of appendicitis are diverse and depend on the form of pathology, the age of the patient and the localization of the appendix. Also, the symptoms depend on the presence of chronic diseases of the gastrointestinal tract, and in women - pregnancy.
Appendicitis: description of the disease
Appendicitis is a pathology of the abdominal cavity, characterized by inflammation of the appendix of the caecum (appendix). In gastroenterology, the disease is considered the most common. Of the total number of hospitalizations in surgery, 89.1% are for appendicitis. The disease occurs in men and women with equal frequency. On average, 5 in 1,000 people aged 10 to 30 are diagnosed with appendicitis annually.
With such a frequency of occurrence of pathology, it is not surprising that some of any discomfort in the abdomen is mistaken for a symptominflammation of the first section of the colon. In order not to panic ahead of time, you should first figure out in which side the appendicitis is located. To do this, it is necessary to refresh the memory of human anatomy.
The appendix is a rudimentary, not fully developed process of the caecum. Its exact localization depends on the location of the caecum. Basically, the rudiment is located in the iliac fossa, and may lie above the intestine or below in the small pelvis, but only on the right side to the bottom.
Classification
When discomfort occurs in the abdomen, many try to remember which side of appendicitis, its symptoms and signs. But if the localization is constant, then the clinical signs have differences that depend on the form of the pathology.
There are two main forms: chronic and acute. Both of them have several options. During acute inflammation of the rudimentary organ, the following forms are distinguished:
- Catarrhal (simple). It is characterized by impaired blood and lymph circulation in the process, the formation of purulent exudate in the mucous layer. Manifestations of appendicitis of this form are distinguished by polymorphism. Pathology can masquerade as various surgical diseases.
- Purulent and phlegmonous (destructive forms). The progression of catarrhal appendicitis leads to purulent. A day later, leukocyte infiltration covers the entire thickness of the wall of the process, which is considered as a phlegmonous form.
- Apostematous. Occurs in about a day, characterized by microabscesses. Manifested by acute pain, fever up to 40 degrees.
- Gangrenous. It occurs as a result of infiltration of the walls of the vessels of the process, which leads to their damage and the formation of blood clots. According to statistics, appendix gangrene is diagnosed in 8.1-8.5% of cases under the age of 20, and after 60 - 30-33%.
Chronic appendicitis is quite rare. There are 3 forms:
- residual - an attack of acute appendicitis, ending in recovery without surgical intervention;
- recurrent - repeated attacks of an acute form with minimal symptoms;
- primary-chronic - sluggish development of appendicitis without acute attacks.
Causes of occurrence
The defeat of the appendix is caused by the bacterial flora that vegetates in the intestine. In the predominant number of cases, the "culprits" of the development of the pathological process are staphylococci, E. coli, diplococci, anaerobes and others.
The process is rich in lymphoid tissue, which makes it a participant in processes accompanied by an immune response. Painful manifestations of appendicitis are associated with the activation of the lymphatic apparatus, which leads to swelling of the rudiment and squeezing of nearby organs.
The presence of pathogenic microflora in the intestines is mandatory. With the help of it, the normal process of digestion is carried out. But under certain conditions, bacteria become hostile and cause inflammation:
- Mechanical blockade of the lumen of the appendix. As a result of the bending of the process of the presence of fecal stones in its lumen,proliferation of lymphoid tissue, stagnation of intestinal contents occurs and inflammation develops.
- Impaired circulation. With poor blood circulation in the walls of the appendix, there is a lack of nutrients, local immunity decreases, which contributes to the activation of pyogenic microbes.
- The nature of nutrition plays a certain role. With the consumption of heavy fatty foods, insufficient fluid intake and a tendency to constipation, excess amounts of ammonia, carbon dioxide and other protein breakdown products accumulate in the intestines. Such conditions are favorable for the development of pathogenic flora.
Manifestation of appendicitis in adults
Inflammation symptoms differ with age. Middle-aged people have the strongest immunity, the body tries to cope with pathogens on its own. In children, the protective functions are poorly formed, besides, small patients are more sensitive.
Unlike children, adults know which side appendicitis is. But this is not enough to recognize an attack of an acute form of inflammation of the appendix. A distinctive symptom of appendicitis is severe pain in the iliac region on the right. As a rule, it appears suddenly. At first, the pain has a diffuse character or is more concentrated under the ribs closer to the umbilical region.
After a few hours, physical suffering intensifies and is more clearly felt in the iliac region on the right. With an atypical location of the process, pain is felt in the lower back, in the pelvic region. Painpronounced, constant, even more aggravated by coughing, laughing. It subsides when lying on the right side.
The inflammatory process is reflected and affects the digestive organs. Therefore, pain is often accompanied by signs of dyspepsia (indigestion): nausea, increased gas formation, upset stool (diarrhea or constipation), vomiting. Intoxication is especially pronounced in purulent, phlegmonous forms.
There is an increase in temperature up to 38 ° C for several hours, an increase in heart rate up to 90-100 beats per minute without physical exertion. In rare cases, inflammation of the iliac and pelvic veins with thrombus formation. This can cause pulmonary embolism.
Symptoms of appendicitis in children
The causes of inflammation of the rudimentary process in children are the same as in adults. But the clinical picture is somewhat different.
Most young children do not even have an idea which side of appendicitis, its symptoms are all the more unknown to them. In children under 2 years of age, inflammation of the appendage of the caecum is rarely observed due to the anatomical features of the rudimentary organ. The main cause of appendicitis at this age is the insufficient development of lymph nodes in the process. By the age of 6-8, the follicles in the lymph nodes are fully formed, the frequency of development of the inflammatory process in the process of the caecum increases.
The main characteristic manifestation of appendicitis in children, as well as adults, is pain. It is localized in the area of the solar plexus closer to the navel, after a whileconcentrating in the right iliac region. If the rudiment is located between the caecum and the abdominal wall, pain is given in the lower back. If there is a high medial location - in the right hypochondrium. Older children easily indicate which side the appendicitis pricks. In addition to pain, inflammation of the appendage of the caecum in young patients is manifested in the following:
- Babies with appendicitis are anxious, cry, press their legs to their stomach, do not allow themselves to be examined.
- Because of constant pain, the child refuses to eat.
- There is repeated vomiting.
- Older children are constipated, small ones have frequent and loose stools with mucus.
- Schoolchildren are characterized by a symptom of "scissors" - a discrepancy between body temperature and pulse rate.
- In the catarrhal form of inflammation, the tongue of children is moist with a coating at the root.
- When phlegmonous - the tongue is wet and all white.
- In the gangrenous form, the child's tongue is dry and white with plaque.
Symptoms of appendicitis in pregnancy
Inflammation of a vestigial organ is the most common abdominal surgical pathology in pregnant women. The disease occurs not only during gestation, but also during childbirth or immediately after them.
The manifestation of appendicitis in girls in position differs depending on the trimester. Symptoms in the first trimester are the same as outside the gestation period. There is a sharp sudden pain in the iliac region on the right. physical suffering canbe intermittent or permanent. There is nausea, diarrhea or constipation, bloating, abdominal muscle spasm. A woman who already knows about her pregnancy may confuse such symptoms with manifestations of toxicosis. This misconception causes a late visit to the doctor, and, as a result, ends in spontaneous abortion.
In the II and III trimesters, women with appendicitis experience severe blurred pain in the anterior abdominal wall. There is an increase in temperature, frequent vomiting.
Inflammation rarely develops during childbirth. But if it happens, it is quite difficult to recognize it. Contractions drown out typical symptoms (pain). Palpation of the right half of the abdomen helps to recognize the pathology: a woman experiences severe pain when pressed, radiating to her leg.
How to recognize appendicitis at home
Inflammation of the appendage of the caecum is a rapidly progressive disease. Delay in seeking medical help can lead to complications. In pregnant women, early recognition will reduce the risk of miscarriage, in the rest - the formation of diffuse peritonitis. There are several ways to determine appendicitis yourself:
- Tactile. A person with signs of appendicitis is laid on his back. The stomach should be relaxed, you can make 2-3 slow deep exhalations. A warm palm is gently placed on the affected area. Then the hand is sharply pulled back. If the pain has noticeably increased, most likely the person has inflammation of the appendix.
- Provocative way. The patient should be made laugh or asked to shout loudly, cough. You can also apply some pressure to the area where you feel the pain the most. If, with these actions, the pain has become more pronounced and acute, most likely the person has appendicitis.
- The patient needs to lie on his right side and bend his knees. In this position, he must be within five minutes. Then the patient should roll over on his left side and fully extend his legs. It is necessary to ask how the person felt during this time. If he says that the pain subsided while lying on his right side, and when he turned over, it intensified even more, this is a confirmation of appendicitis.
What to do if symptoms point to appendicitis?
Inflammation of the appendage of the caecum is a fairly common pathology. It can occur in men and women of any age. The main symptom of the disease is pain. With painful sensations in the umbilical region on the right, you should not waste time and find out where and how appendicitis hurts. Also, do not take painkillers. You need to call the ambulatory medical team. Only a doctor can make an accurate diagnosis and provide adequate treatment.
What diseases does appendicitis have similar symptoms
Appendicitis is an inflammatory process that develops in a confined space in close proximity to many internal organs. Pathological manifestations are often confused with signs of inflammation of other organs.
Differential diagnosisis to compare the clinical symptoms of appendicitis with similar manifestations of other diseases:
- Stomach ulcer. Main signs: severe pain in various areas of the abdomen, vomiting that brings relief, bloating, heaviness in the abdomen.
- Acute cholecystitis is accompanied by severe acute pain in the right hypochondrium, nausea, fever.
- Ileus or bowel obstruction. The disease is characterized by unbearable prolonged abdominal pain, stool retention.
- Acute pancreatitis - epigastric pain. True, unlike appendicitis, in the supine position, the pain increases.
- Enterocolitis is accompanied by painful sensations in the abdomen, aggravated by tension of the abdominal muscles (laughter, physical activity) and defecation disorder.
- In pregnant women, appendicitis should be differentiated from pathologies of the gastrointestinal tract, inflammation of the ovaries.
- Ectopic pregnancy. The pathology is characterized by cutting pain at the location of the fallopian tube, high temperature.
Appendicitis Prevention
At the first manifestations of appendicitis, you should seek medical help as soon as possible. Taking timely action can often help avoid surgery.
Although no one is immune from the development of inflammation, it is possible to reduce the risk of appendicitis. To do this, you must adhere to certain recommendations:
- watch your diet. Eat less junk food and more high-fiber, vegetables, fruits;
- consume more juice, water, tea (bettergreen);
- monitor the chair: regularity, consistency;
- in the event of an infectious disease, consult a doctor, and do not self-medicate. Perform the therapy in strict accordance with the recommendations of the doctor;
- avoid obesity;
- during sedentary work, do exercises that improve blood circulation in the abdomen.
Of course, you should see a doctor so as not to start the disease.
