In the article, we will figure out which side of appendicitis is in a person and what are its signs. This pathology is an inflammatory process in the appendix, which extends from the caecum. This is one of the most common ailments in surgery.
Essence of pathology
Appendicitis is one of the most common abdominal surgical diseases, accounting for 89.1 percent. Appendicitis can occur in both men and women at any age. The culmination of the incidence is observed in the category of patients from ten to thirty years. The development of the inflammatory process in the appendix occurs in five people out of a thousand a year. Appendicitis is under the jurisdiction of abdominal surgery, or operative gastroenterology.
What is an appendix?
This is an appendage of the caecum, which has a rudimentary character. Outwardly, it is an elongated narrow tube, the distal side of which has a blind ending, and the proximal side is connected to the cavity of the cecum with the help of a funnel-shapedholes.
How to determine appendicitis at home, many people are interested.
There are four layers in the wall of the appendix: serous, muscular, submucosal and mucous. The length of the process is from five to fifteen centimeters, the thickness is from seven to ten millimeters. The appendix has its own mesentery, which holds it and ensures the mobility of this process.
Its functional purpose has not been fully clarified, but it has been proven that the appendix has the following functions: barrier, endocrine and secretory. In addition, it is involved in the maintenance of intestinal microflora and the formation of immune responses. Everyone should know the signs of appendicitis.
Disease classification
There are two main types of appendicitis - chronic and acute. Each of them has several morphological and clinical variants. In acute appendicitis, there are catarrhal (simple) and destructive forms (gangrenous, apostematous, phlegmonous-ulcerative and phlegmonous).
With catarrhal appendicitis in adults, there are symptoms of disorders of the lymph and blood circulation in the process, the appearance of foci of purulent-exudative inflammation in the mucosal layer. The appendix increases, its serous membrane becomes full-blooded. There is an attack of appendicitis.
Due to the development of catarrh, a purulent ailment occurs in an acute form. A day after the start of the process, leukocyte infiltration spreads over the entire thickness of the appendix wall, and this is regarded as phlegmonous appendicitis. This form is characterized by a thickening of the appendix wall, edema and hyperemia of the mesentery, the release of a purulent secret from the lumen of the appendix.
Signs of inflammation of appendicitis, of course, are pronounced. But sometimes the picture is blurred. If a large number of microabscesses form during inflammation of a diffuse nature, then apostematous appendicitis is formed; if there are ulcerations in the mucosa, then phlegmonous-ulcerative appendicitis develops. The progression of destructive processes in the future becomes the cause of gangrenous appendicitis. When tissues that surround the appendix are involved in the purulent process, it is accompanied by the appearance of periappendicitis, while mesentericitis develops in the mesentery. Complications of acute (mainly phlegmonous-ulcerative) type of appendicitis is perforation of the process, which leads to limited or diffuse peritonitis, or appendicular abscess.
Among the types of chronic appendicitis are primary chronic, residual and recurrent forms. The course of the disease is characterized by sclerotic and atrophic processes in the process, destructive and inflammatory changes with further growth in the appendix wall and the lumen of the granulation tissue, the appearance of adhesions between the tissues and the serous membrane. When serous fluid accumulates in the lumen, a cyst appears.
Signs of appendicitis will be discussed in more detail below, but for now let's talk about the causes of this pathology.
Causes of appendicitis
Appendicitis develops, as a rule, due to the polymicrobial flora, which is represented by staphylococci, anaerobes, streptococci, E. coli and enterococci. Pathogens penetrate the appendix wall in an enterogenic way, that is, from the lumen.
Appendicitis develops when intestinal contents stagnate in the appendix due to its kink, the presence of fecal stones and foreign substances in the lumen, hyperplasia of the lymph tissue. Mechanical blockage of the lumen causes an increase in pressure inside it, circulatory defects in the appendix wall, which is accompanied by a decrease in local immunity, an increase in the activity of pyogenic bacteria and their further penetration into the mucosa.
Food
Features of nutrition and specific location of the process are of certain importance. This predisposes to the formation of appendicitis. It is known that due to excessive consumption of meat and a person's tendency to constipation, a large amount of protein decay products accumulate in the intestinal contents, and this creates an excellent environment for the existence of pathogenic flora. In addition to mechanical causes, appendicitis develops due to parasitic and infectious diseases - typhoid fever, yersiniosis, intestinal tuberculosis, amoebiasis, etc.
Pregnant women
Pregnant women are more likely to develop appendicitis. This is due to the displacement of the appendix and the caecum due to an increase in the size of the uterus. Also predisposing factors in pregnant women are constipation, changes in blood supplypelvic organs, transformation of the immune system.
Signs of appendicitis
If acute appendicitis has a typical form, then there are pains on the right side in the iliac region, pronounced general and local reactions. In this case, an attack of pain most often develops abruptly. At first, it spreads or is localized most often in the area near the navel and in the epigastrium. After a few hours, there is a concentration of pain in appendicitis in the iliac region on the right side.
If the appendix is located atypically, then unpleasant symptoms may be felt in the lumbar region, in the right hypochondrium, above the pubis and near the pelvis. Pain syndrome in acute form of appendicitis is expressed all the time, increases during laughter or coughing, decreases on the right side in the supine position.
Early symptoms
Typical early signs of appendicitis are symptoms of a digestive upset: vomiting, nausea, diarrhea, gas and stool retention. Tachycardia and subfebrile condition are noted. Intoxication is especially pronounced in destructive appendicitis. The course of the disease can be complicated by abscesses of the peritoneal cavity - Douglas, interintestinal, subdiaphragmatic and appendicular space. In some cases, thrombophlebitis of the pelvic or iliac veins is formed, which can become a source of PE.
In children and the elderly
Special specificity of signs of inflammation of appendicitis is in the clinic of pathology in the elderly, pregnant women, children,patients who have an atypical location of the appendix.
For children at an early age with acute appendicitis, the following symptoms are observed, characteristic of various childhood infections: diarrhea, febrile temperature, frequent vomiting. The child's activity decreases, he becomes lethargic and capricious. As the pain syndrome increases, there may be anxiety.
The attack of appendicitis in the elderly is somewhat different. Elderly patients with appendicitis usually have a blurred clinical picture. The disease often passes areactively, including in destructive types of the disease. Body temperature does not always rise, pain in the hypogastrium is insignificant, the pulse is within normal limits, signs of abdominal irritation are weak, slight leukocytosis. Older patients, especially if there is a palpable infiltrate in the ileum, require differential diagnosis of the pathology with a tumor in the caecum. For this purpose, it is necessary to conduct an irrigoscopy or a colonoscopy.
If appendicitis is diagnosed in pregnant women, then the pain can be localized much higher than the location of the iliac region due to the displacement of the caecum upwards by the enlarged uterus. Other symptoms of appendicitis may be milder. Acute appendicitis in pregnant patients must be distinguished from the risk of spontaneous miscarriage, as well as premature birth.
In the chronic form, there are dull aching pains with appendicitis in the iliac region on the right. They may increase from time to timefeatures during physical exertion.
Appendicitis clinic is characterized by signs of digestive disorders (persistent diarrhea or constipation), feelings of heaviness and discomfort in the epigastric region. Body temperature is within normal limits, clinical blood and urine tests do not have pronounced changes. During deep palpation, pain is felt in the abdomen on the right.
How is appendicitis diagnosed?
Diagnosis of disease
Acute appendicitis must be distinguished from almost all pathologies of the organs of the peritoneal cavity. This is facilitated by the specific location of the process, as well as the absence of typical symptoms. How to determine appendicitis at home? Appendicitis is diagnosed on the basis of a medical examination and questioning, ultrasound data, as well as laboratory blood tests. During pressure on the abdomen on the right, pain intensifies, but they become especially strong when the pressure of the fingers on the wall of the peritoneum is abruptly removed.
When the patient is asked to stand on tiptoe, he cannot do this due to increased pain. The number of leukocytes can either increase or decrease, but there is always a sudden neutrophilic shift. Diagnosis of appendicitis should be timely.
Features of treatment
Generally accepted for acute appendicitis is the tactic of surgically removing the affected appendix as quickly as possible.
If there is a suspicion of such a disease, then before treatment inin a medical institution, the intake of food and liquids is excluded, application of cold to the iliac region on the right and bed rest are shown. It is strictly forbidden to drink laxatives, use heating pads, and also administer analgesics until the diagnosis is fully established. What kind of surgery is performed to remove an appendicitis?
In the acute form, an appendectomy is performed, that is, the removal of the process by laparoscopy or through an open incision in the iliac region on the right. If appendicitis is complicated by peritonitis, a median laparotomy is performed. The patient is taking antibiotics in the post-op period.
In the chronic form, an operation to remove appendicitis is indicated - appendectomy, if there is a persistent pain syndrome that deprives the patient of normal activity. If the symptoms are mild, then conservative treatment is used, which includes the use of antispasmodics, physiotherapy and the elimination of constipation.
Forecast
Which side of a person's appendicitis is very important to know in order to have time to determine it.
If the operation is carried out on time and correctly, then the prognosis is favorable. It usually takes three to four weeks to get back to work.
Complications may be the appearance of an inflammatory infiltrate after surgery, an abscess of the interintestinal and Douglas space, the development of obstruction of intestinal adhesions. These conditions require repeated emergency hospitalization.
Such complications, as well as death, can bea consequence of late hospitalization, as well as an operation performed untimely.
We looked at the signs and treatment of appendicitis.
