Appendicitis is a rather dangerous disease for its consequences. That is why the main task of a specialist is to diagnose him as quickly and accurately as possible. A number of signs help to recognize the disease, named after the researchers who first identified them - the symptoms of Rovsing, Sitkovsky, Bartomier-Michelson, Voskresensky, and so on. Let's take a closer look at them.
Causes of appendicitis
There are several causes of appendicitis:
- Obstruction of the entrance to the vermiform end of the rectum is the most common. This can happen due to the ingress of foreign bodies, feces. Blockage can also occur from squeezing the upper part of the appendix with formations of adhesive processes in enteritis and cholecystitis.
- Stagnation of the contents of the process. This leads to a weakening of its protective functions, which is why pathogenic bacteria - staphylococci, E. coli, streptococci - begin to actively multiply in the appendix. They cause inflammation.
- Spasm of blood vessels that supply blood to the appendix.
- Injury to the peritoneum, which may result in displacement or injuryappendix.
- Pregnancy. The process may be displaced due to the growth of the uterus.
- Tendency to constipation.
- Poor intestinal peristalsis.
- Overeating.
- Lack of plant fibers, trace elements, vitamins in the diet.
- Diseases of the gastrointestinal tract.
- Hereditary factors.
- Infectious diseases.
- Presence of parasites.
- Bad habits.
- Stress.
About the diagnosis of appendicitis in Russia
Appendicitis - inflammation of the appendix of the rectum. For its primary diagnosis, confirmation or refutation of the diagnosis, doctors in Russia use certain symptoms of peritoneal irritation that have been tested for years. There are few of them, but they are reliable "old-timers" in clinical practice. Named after their author:
- Sitkovsky's symptom.
- Kocher's symptom.
- Symptom of Resurrection.
- Obraztsov's symptom.
- Rovsing's symptom.
- Shchetkin-Blumberg symptom.
The manifestation of each of them depends on a number of factors: the location of the appendix, the cause of inflammation, the neglect of the disease, and so on. Let's analyze the symptom of Sitkovsky and others in more detail.
Kocher's sign
The surest sign by which acute appendicitis can be identified is Kocher's syndrome. There is even an expression among doctors: "Kocher does not lie." Half of patients suffering from appendicitis have this symptom.
It manifests itself in the following: pain from the epigastric region gradually migrates to the right iliac. It is determined when collecting an anamnesis, questioning the patient - clarifying the place of occurrence of the pain syndrome, its nature.
Sitkowski's symptom
With appendicitis, doctors still overwhelmingly prefer this symptom. The main reason for this is that it can be quickly and easily checked.
Manipulations are as follows: the patient is asked to lie on his left side and describe his feelings. With this movement, the intestinal loops are displaced, dragging the inflamed process with them. Therefore, the patient in the presence of appendicitis will inevitably complain of increased pain.
Symptom of Resurrection
Another name is "shirt symptom". The sign helps to diagnose not only appendicitis, but also other inflammatory processes in the abdominal cavity. Therefore, in clinical practice, it is as popular as Sitkovsky's symptom.
It is checked as follows: a slightly stretched shirt, which is worn on the patient, is quickly carried out with the edge of the palm over several areas in the abdomen. If during these actions the patient will feel pain in the right iliac region, then he can be diagnosed with appendicitis.
Shchetkin-Blumberg symptom
Another sign of peritoneal irritation as famous as Sitkowski's symptom. It is considered a reliable test for peritonitis, whyused for all complaints of abdominal pain.
It is necessary to perform the following actions: the doctor slowly puts his hand on the patient's anterior abdominal wall and gently, without effort, presses. Then he abruptly withdraws his hand. If at the same time the patient felt a sharp pain, then the Shchetkin-Blumberg symptom was confirmed. In the acute form of appendicitis, the patient will feel pain during this in the right iliac region.
Rovsing's sign
It is rather rarely used in practice, which does not negate its fidelity, which is why the symptoms of Rovsing and Sitkovsky are constantly mentioned in the literature. It is determined when a pain syndrome appears during the accumulation of gases in the rectum.
The doctor performs the following manipulations: in a lying patient, it is necessary to squeeze the colon descending intestine in the left iliac part of the peritoneum with a hand. At the same time, with the right hand, make jerky pressure slightly higher. If, with such a change in pressure in the intestinal tract, the patient feels pain in the right iliac region, then he is diagnosed with appendicitis.
Obraztsov's symptom
After we talked about the symptoms of Rovsing, Sitkovsky, Voskresensky, it would not be superfluous to tell about Obraztsov's sign, which helps to identify the retrocecal location of the appendix.
The patient is asked to lie on his back and raise the right leg straightened at the knee. At this time, the muscles of the anterior abdominal cavity and lower back tense up and begin to act on the receptors of the appendix. If the latter is inflamed, the patient will complain of pain in the right iliac region.
Other symptoms
We have analyzed a number of appendicular symptoms, Sitkovsky's symptom. Let's get acquainted with the less common, but taking place in medical practice, methods for diagnosing acute inflammation of the appendix:
- Bartomier-Michelson symptom. The patient lies on his left side, and the doctor, palpating the right side of the peritoneum, finds a painful place.
- Varlamov's symptom. When tapping in the region of the right XII rib, pain occurs in the characteristic right side of the peritoneum.
- Ben Asher's symptom. The doctor presses with the tips of two fingers into the left hypochondrium of the patient. The patient is asked to breathe deeply or cough. If during this manipulation there is pain in the right iliac region, there is a suspicion of appendicitis.
- Asaturyan's symptom. The doctor presses with the fist of his right hand on the left iliac region of the patient. On the protruding right area with his free hand, the specialist palpates the caecum for the localization of pain.
- Bassler's symptom. Tenderness is determined by pressing between the superior anterior iliac spine and the navel towards the spine of this bone.
- Iliescu's symptom. Soreness in the characteristic zone occurs when pressure is applied to the cervical point of the right diffraction nerve.
- Brendo's symptom. It is used in the diagnosis of appendicitis in pregnant women. When pressing on the left rib of the uterusthere is pain in the right area of the peritoneum.
- Zutler's Syndrome. The patient in a sitting position is asked to straighten his right leg. With inflammation of the appendix, the patient will feel pain in the right iliac region during this movement.
- Cope's symptom. Rotation of the right hip increases pain in the right iliac zone.
Consequences of acute appendicitis
Complications of appendicitis are divided into two groups:
- Preoperative. Their reasons:
- Sick held out seeking medical help.
- The attending physician misdiagnosed.
- The operation was carried out with errors.
- Inflammation gave rise to new diseases or the development of chronic ones.
- Postoperative. Their reasons:
- Failure to follow doctor's recommendations after surgery.
- Inflammation of the surgical wound.
- Inflammation of nearby organs, peritoneum.
Thus, appendicitis is not the most dangerous inflammatory process that can be easily eliminated by surgery. Its following complications are terrible:
- Perforation is an early type of complication that develops along with peritonitis. It is characterized as purulent fusion of the walls of the appendix and outpouring of pus into the abdominal cavity.
- Appendicular infiltrate - develops in patients who applied for help late. This is the spread of inflammation from the process to neighboring organs.
- Appendicular abscess is a rare form of complication. itpurulent inflammation in the right iliac region, between the intestinal loops, under the diaphragm, in the retroperitoneal space.
- Pylephlebitis is a severe purulent-septic inflammation of the portal vein of the liver, in which many abscesses form. Dangerously fatal.
- Peritonitis - inflammation of the peritoneum.
- Intestinal fistulas - a consequence of errors during the operation. This is an accidental lesion of the intestinal loops during the removal of the appendix.
We have analyzed the disease in which the symptom of Sitkovsky, Obraztsov, Voskresensky and so on is observed. As you have seen, with the help of these diagnostics, you can easily and quickly determine appendicitis in a patient.
