Gangrenous appendicitis is a pathology that is characterized by tissue necrosis of the vermiform segment and a typical clinical picture, which makes it possible to differentiate it from other forms of the inflammatory process directly in the appendix. Most often, it is acute and provokes the development of quite serious he alth consequences. That is why it is so important to seek help from a doctor in a timely manner, who will determine the causes of the pathological process and prescribe therapy.
General information
Gangrenous appendicitis is a kind of purulent variant of inflammation of the appendix, which is based on irreversible destruction. Most often, changes of a necrotic nature are observed in small areas of the appendix. Gangrenous inflammation is a form of an acute variant of the disease and appears only at a certain stage of its development (2-3 days of inflammation).
Main causes of pathology
Acute gangrenous appendicitis develops when the inflammatory process in the process was not noticed during the first day. Thenthe normal sensitivity of the nerve endings disappears, so the pain syndrome may disappear. Many patients decide that the danger has passed, you can postpone the visit to the doctor for a while. This neglect of one's own he alth can lead to peritonitis.
The main risk factors for the occurrence of such a pathology, experts include the following:
- Old age.
- Clot formation.
- Atherosclerosis of the intestinal arteries.
All these factors indicate that the direct causes of the development of pathology are the so-called microcirculatory disorders. Their result is a violation of normal blood circulation, as a result - necrosis of the process. Other elements of pathogenesis (infection, autoaggression of immune cells) join only in the second place, only aggravating the course of the pathology.
What signs indicate pathology?
In the acute period, repeated vomiting occurs, which constantly exhausts the patient and does not bring long-awaited relief. Due to intoxication of the body due to the development of a putrefactive inflammatory process, the temperature may remain normal or low.
Gangrenous appendicitis manifests as toxic scissors syndrome. The patient has a pronounced tachycardia (heart rate of about 100 beats per minute), but the temperature does not rise.
The patient's tongue is dry with a characteristic yellowish coating. In the case of primary gangrenous appendicitis, the symptoms may vary slightly:
- Pain discomfort in the right iliac zone, which suddenly appears and quickly subsides.
- The abdomen is hard, painful.
- The patient's condition is regarded as serious.
If a person does not receive adequate and timely treatment, after this form of the disease, gangrenous-perforated appendicitis develops. Pathology is characterized by perforation of the wall of the appendix itself. During the period of its immediate rupture, a person experiences severe pain, which over time begins to gradually spread throughout the abdomen. Due to the increasing intoxication of the body, the temperature rises, an obvious tachycardia appears. The tongue becomes very dry, the coating acquires a brownish tint. The patient is suffering from severe vomiting.
Diagnostic measures
If you have the above symptoms, you should immediately seek medical help. If this pathology is suspected, the specialist initially conducts a physical examination of the patient. On palpation, as a rule, tension of the abdominal wall is observed, the abdomen is moderately swollen. A series of laboratory tests are then ordered, including blood and urine tests. Additionally, ultrasound, X-ray and computed tomography may be required. Based on the results of the tests, the doctor can confirm the diagnosis of gangrenous appendicitis.
Treatment methods
Therapy involvessurgical removal of the appendix. Appendectomy is performed in the traditional way or through laparoscopy.
In the first case, the doctor removes the appendix through an incision in the abdominal wall. Typically, this procedure is performed using general anesthesia.
Surgery for appendicitis through laparoscopy is characterized by low trauma. The surgeon makes several microscopic punctures in the abdominal wall, through which instruments for manipulation are inserted. The most important of these is the laparoscope - a tube with a camera at the end. During the operation, the doctor receives an image from it on the computer screen, which allows the most accurate surgical manipulations.
Post-operative period
The postoperative period in patients with such a fairly common diagnosis has a number of features:
- Using antibacterial and pain medications.
- Infusion detoxification therapy using saline solutions, refortan, glucose and albumin.
- Daily blood tests.
- Prevention of ulcers and thromboembolic complications. In the postoperative period, patients are prescribed blockers of gastric secretion ("Kvamatel", "Omez"), anticoagulants ("Clexane").
- Daily dressings and washing of wounds.
- exercise therapy, special massage, breathing exercises.
Appendicitis surgery is quite a serious surgical intervention. To prevent the development of complications in the future, you should usethe recommendations below.
Let's talk about nutrition
This pathology is characterized by problems with intestinal motility, so after surgery, special attention should be paid to nutrition.
On the first day, low-fat yogurt, mineral water without gases and light chicken broth are allowed. On the second day, if the postoperative period is not complicated by negative consequences, you can add mashed potatoes, liquid cereals on the water and cottage cheese casserole to the diet. A day later, food must be diversified as part of diet No. 5. It is better to give up fatty, spicy foods and smoked meats.
Probable Complications
This pathology is considered very dangerous, as it can lead to the development of quite dangerous he alth complications. This process is especially critical for young patients.
What are the negative consequences of gangrenous appendicitis?
- Purulent peritonitis. This is a rather dangerous condition that requires immediate surgical intervention. If help is not provided in a timely manner, blood poisoning may occur.
- Appendicular infiltrate. In the area of the inflamed process, a local conglomerate is gradually formed, consisting mainly of organs and tissues. This problem always requires long-term conservative therapy.
- Septic thrombophlebitis. The inflammatory process develops in the venous walls. As a result, it leads to the formation of blood clots in the lumen of the vein.
- Local purulent abscess. Such formations mainly develop in the area of the diaphragm.
Appendicitis should not be ignored. The purulent gangrenous variant of this pathology requires immediate treatment. Otherwise, the likelihood of complications and even death increases. Such inflammation is especially dangerous for children, in them all pathological processes proceed several times faster.
