Statistics show that in the field of surgery, appendicitis is the most common disease and accounts for 90% of all operations. This pathology does not select people by age or gender.
Appendicitis goes through several stages. Catarrhal appendicitis is a reversible stage. Occurs in 90% of cases and is often referred to as simple appendicitis.
Etiology
Specialists of clinical medicine identify several reasons that provoke the development of pathology:
- existing pathogens in the body;
- gut bacteria;
- incorrect work of the appendix during contractile movements;
- get particles, undigested food and stones;
- inflammatory processes in other organs, which eventually move to the appendix.
Theoretical foundations of risk factors
In fact, modern doctors have not come to a consensus on why catarrhal appendicitis occurs. There are several theoriesorigin of the disease, and each has the right to exist:
- Mechanical theory. It is assumed that the disease occurs against the background of blockage of the process with fecal stones, tumors and even worms. The inflammatory process can begin against the background of a kink of the process or develop in the presence of adhesions in the abdominal region.
- Allergic theory. It is believed that when types 3-4 of an allergic reaction occur, the protective functions of the process walls are significantly reduced, and microbes and bacteria penetrate there without any problems, as a result, the inflammatory process begins.
- Infection theory. This theory strongly intersects with the mechanical one. It is believed that infectious agents must be present in the body for inflammation of appendicitis.
- According to the vascular theory, it is assumed that catarrhal appendicitis appears against the background of the development of systemic vasculitis on the walls of the process vessels.
- Alimentary theory. It is based on the assertion that the development of the disease is associated with malnutrition. The disease occurs against the background of the use of a large amount of protein while reducing fiber intake. As a result, the process of passing food through the intestine becomes more difficult, and the inflammatory process begins.
Adherents of different theories agree on the existence of several major risk factors for the development of pathology. These include:
- infectious diseases;
- bad habits;
- injuries in the gastrointestinal tract;
- malnutrition;
- dysbacteriosis.
Pathogenesis
The symptoms of catarrhal appendicitis have many similarities with signs of abdominal diseases.
Simple appendicitis is superficial, and infiltration is present only on the mucous membrane. At the beginning of the inflammatory process, pain is observed in the navel. Over time, in most patients, the pain begins to migrate, appear on the right side, and radiate to the rectum. When you try to turn to the left side, the pain in the side increases.
Localization of pain largely depends on the location of the appendix. The overall he alth of the patient also has a huge impact on the symptoms.
In addition to pain, there is an increase in body temperature. Diarrhea or, conversely, constipation may begin. Often there is dry mouth, vomiting and general weakness throughout the body.
At the first suspicion of acute catarrhal appendicitis, you should immediately contact a medical facility. With young children, everything is much more complicated, they cannot talk about their feelings. Therefore, parents should pay attention to the behavior of the baby: he becomes lethargic, capricious, often puts his hands on his stomach, sleeps poorly, his temperature rises.
Stages of disease
There are four stages of the disease, depending on the neglect of the disease:
- Catarrhal form of appendicitis or the first stage. Symptoms appear in the evening or at night. There is a lingering pain in the stomach, later vomiting begins. The patient may feel that he has begungastritis, the abdomen is soft, and the pains gradually move to the right side. The stage lasts about 12 hours, and this is the most favorable period for the operation, but at this stage, rarely anyone seeks help.
- The next stage is catarrhal phlegmonous appendicitis. This stage lasts about a day. The pains become pulsating, the heart beats faster, the body temperature rises, but not higher than 38 degrees. On palpation, hardening is observed on the right side of the lower abdomen.
- Gangrenous form begins already on the second or third day after the first symptoms appear. The process of dying off of the nerve endings of the organ develops, so the pain subsides. Body temperature drops to 36 degrees. Increased pain is typical only for the palpation procedure.
- At the last perforative stage, through holes appear in the organ. The pain is constant and severe. There is bloating, tachycardia. A dark brown coating appears on the tongue.
Forms of illness
There are two main forms of the disease: acute and secondary catarrhal appendicitis.
The first form is named so because during it the inflammatory process develops rapidly. This pathology occurs most often, without choosing a patient by age or gender. As a rule, the process is blocked by feces, helminths or foreign bodies.
And about the second form, it should be noted that secondary catarrhal appendicitis is a pathology that is a consequence of the transition of the inflammatory process to the appendix withother organs: stomach, gallbladder.
Diagnostic measures
If you suspect you have appendicitis, you should immediately contact a medical facility. The doctor takes a history and conducts an examination. There are several methods that allow you to establish a primary diagnosis.
First of all, the patient is asked, when he is in a horizontal position, to turn on his left side. If at the same time the pain intensifies, then most likely that the diagnosis is indeed correct, this sign is called Sitkovsky's symptom.
Rovsing's symptom consists in the fact that when the sigmoid colon is compressed, the patient begins to experience severe pain. Under the symptom of Moscow understand the condition in which the patient's pupil in the right eye slightly dilates.
Be sure to take material for blood and urine tests.
Instrumental diagnostics may also be required, in particular:
- ultrasound;
- CT, MRI;
- radiography.
Instrumental techniques allow a 100% accurate diagnosis.
If diagnosed too late or given inadequate treatment, there is a high risk of sepsis, internal bleeding, or adhesions.
Differential Diagnosis
In most cases, a differential diagnosis is required to establish a clear diagnosis. Indeed, at any stage of catarrhal appendicitis, the symptoms may be too similar to those of other diseases:
- cholecystitis;
- pancreatitis;
- ulcer;
- gastroenteritis and others.
That is, in order not to confuse inflamed appendicitis with other diseases in the abdominal cavity, differential diagnosis is carried out.
Treatment
As soon as it is suspected that an incoming patient has inflammation in the area of appendicitis, he is immediately sent to the surgical department. After that, all examinations are carried out urgently to clarify the diagnosis and provide assistance.
Many are interested in if catarrhal appendicitis is diagnosed, whether an operation is needed. Alas, surgical intervention is indispensable.
Today, the operation can be performed laparoscopically, transluminally or laparotomically.
The first technique is most often used, it is not so traumatic for the patient. The surgeon makes small incisions through which he removes the inflamed process. The transluminal method involves removing the appendix through the stomach or vagina.
Laparotomy surgery is most often performed in the secondary form of the disease or if there are suspicions that other organs are affected. In such cases, an incision up to 10 centimeters long is made, and the damaged organ is removed. At the same time, the doctor can clearly see if there are any problems with other internal organs.
If no complications occurred during the operation, the recovery process lasts no more than 10 days. During the recovery period, the patient is prescribedantibacterial agents, if necessary, painkillers.
Rehab
For several months after the removal of appendicitis, you must follow a diet. 12 hours after the operation, the patient can drink broth, jelly or tea. And on the second day he is transferred to a fractional 6 meals a day. A detailed diet for the patient should be made by a doctor.
In the process of rehabilitation, it is allowed to use vegetable soups, with onions, potatoes, carrots. Suitable pasta, mushrooms, baked vegetables, lean meat and fish, boiled and steamed. You can eat low-fat dairy products, fruits and herbal teas.
It is mandatory to exclude smoked products, pickles, seasonings, sweets, borscht, fatty broths and meat.
During the rehabilitation period, it is recommended to take daily walks, go to the pool or do other light sports. If the patient is overweight, it may be necessary to wear a bandage for a while.
Prevention
To date, there are no clear reasons why catarrhal appendicitis appears. For this reason, there are no effective preventive measures. However, doctors recommend not to abuse alcohol, not to get involved in "harmful" food, eat rationally, as far as possible, eat foods high in minerals and vitamins.
