Appendicitis is characterized by inflammation of the appendix, which is a small (about 9 cm) appendage of the caecum. Due to the characteristics of the body, it is able to become inflamed and provoke the development of the most common surgical disease. Therefore, it is especially important to diagnose this pathology in time.
The basics of disease
If urgent measures are not taken in the acute form of appendicitis, the pathology can be life-threatening, as it leads to perforation of the appendix and purulent diffuse peritonitis.
The main symptom of acute appendicitis is a sudden onset of abdominal pain. The pain syndrome is characterized by the following symptoms:
- initially sensations are aggravated in the epigastric region;
- after 6-8 hours the pain moves to the right iliac region;
- later it becomes diffuse;
- pain manifests itself constantly, with periodic intensification and weakening, but there are no painless moments;
- with any movement, pain increases, so a person with acute appendicitis moves with his hand on the right side of the abdomen, which is one ofcharacteristic symptoms of this disease;
- acute pain indicates purulent inflammation;
- decrease in pain in the acute form of the course indicates the beginning of the gangrenous process and the death of nerve endings.
Diagnostic nuances
Usually, the disease does not cause difficulties in diagnosing. Appendicitis is determined on the basis of its characteristic signs, which include positive symptoms of Rovsing, Sitkovsky and others.
So, when determining the latter, the pain on the right in the iliac region increases when the patient lies on the left side. According to Sitkovsky's observations, the injection of pain is due to the fact that the caecal process is stretched and its deformation causes pain. The pain is aggravated by the tension of the mesentery of this process.
And Rovsing's symptom with appendicitis is characterized by the appearance of pain in the right iliac region, if the doctor makes jerky palpation in the projection of the lateral canal, in the left side of the abdomen (from left to right).
The signs below are also among the most significant:
- Symptom of Bartomier - Michelson - the appearance of pain during palpation of the cecum, if the patient lies on his left side.
- Obraztsov's symptom is an increase in pain when applying pressure on the caecum, with a simultaneous attempt to raise the straightened right leg.
Detailed consideration of Rovsing's symptom
Rovsing's symptom is an increase in the painful condition on the right when applying pressureon the sigmoid colon (it is located in the left iliac region) and in the manifestations of convulsive spasms above it. When examining the abdominal wall in the left part of the iliac region, they press with the fingers of the left hand, gathered together, and without taking them away, a short push is made with the right hand on the area of the large intestine lying above. Rovsing's symptom is designed for the movement of gases during the push.
However, in some cases, when examining a patient, it is difficult to make a correct diagnosis, since Rovsing's symptom may be absent. It is especially difficult to distinguish from the manifestations of the described disease the symptoms of a ruptured abdominal aortic aneurysm, with the spread of blood in the right iliac zone.
Rovsing's symptoms are not used very often, but they are, by the way, considered one of the most reliable for the correct diagnosis of appendicitis.
The importance of a correct diagnosis
In modern medicine, with a mild form of appendicitis, laparoscopic operations are performed that do not require the creation of an abdominal incision. In this case, an endoscopic instrument is inserted into the abdominal cavity through a small incision in the tissue. This method allows you to avoid surgical intervention, as well as significantly reduce the rehabilitation period. The risk of postoperative complications after laparoscopic appendectomy is minimal.
But, unfortunately, the symptoms of appendicitis are periodically confused with manifestations of other pathologies:
- pancreatitis;
- renal colic;
- acute cholecystitis;
- gastric ulcer;
- acute inflammation of the bladder and female organs.
Positive Rovsing's symptoms and other signs play an important role in diagnosing the named pathology, but in cases of an abnormal position of the process, the clinical picture can be blurred. Therefore, it is very important to pay attention to the peculiarities of the pain that has arisen in a timely manner.
In order to avoid serious consequences, you should seek specialized medical help, otherwise it may end tragically. It is important to understand that self-diagnosis in such cases is extremely dangerous.
