Symptom of Kocher. Characteristic signs of appendicitis.

It is difficult to overestimate the importance of timelydiagnosis of acute appendicitis. After all, ignoring the characteristic signs can cause peritonitis and lead to death. One of them is Kocher's symptom. But, unfortunately, it is not observed in all patients.

Symptom description

There are many signs thatThe patient began an inflammation of the appendix. But one of the very first is the following symptom. First, the pain occurs in the epigastric region. Also called the epigastric. It is located immediately under the xiphoid process - the shortest part of the sternum, to which the ribs in front converge.

The symptom of Kocher-Volkovich is that1-3 hours after the onset of pain, the person notes that they are moving to the iliac region. As a rule, they are localized below, in the right part of the abdominal wall.

To alleviate the condition, patients often take this position: they lie on the right side, legs are bent at the knees and pulled to the stomach.

Characteristic signs of appendicitis

In the initial stages, not everyone is suspicious.inflammation of the appendix. Often, problems begin with discomfort in the gastrointestinal tract. There are pains in the epigastric region, sometimes they are localized in the region of the navel. This is the symptom of Kocher with appendicitis. Many note the sensations of colic, bloating and feelings of distention. After the release of gases or defecation, the condition may improve for a while.

But the pain intensifies after 1-3 hours.Hot flashes are replaced by constants. The pains are arching and oppressive. Discomfort moves down the abdomen. In this case, any movement and load only worsen the situation. The pains are aggravated by taking deep breaths, coughing, walking, riding a vehicle (with shaking). This is observed equally in both adults and children.

Localization of the inflamed process

Knowing that Kocher's symptom is observed in acuteappendicitis, you can diagnose the onset of this disease. Also on the localization of pain, you can understand exactly where this organ is located. In the standard classic version of the location it will be on the right side. But if the pain is localized elsewhere, then it is possible that it is placed differently. This must be remembered when conducting diagnostics.

So, if the pains are concentrated in the region of the womb andthe lower right abdomen, the pelvic position of the inflamed organ can be observed. With its location in the area of ​​the medial (middle) line of the body, the discomfort will be localized in the area of ​​the navel.

Sometimes pains are concentrated in the lumbar region,groin and genitalia. This may indicate that the appendix is ​​located behind the cecum. However, in this case it is important to conduct a differential diagnosis and exclude renal pathologies or lesions of the ureter.

Pains in the left lower abdomen are rarely observed. This means that the appendix is ​​located outside the box. He, along with the caecum is on the left.

Diagnostics

In order to determine appendicitis, it is not enough to knowjust a symptom of Kocher. There are a number of other signs by which you can make an accurate diagnosis. So, the patient can not sit down from the supine position without help. This is called a Bailey symptom.

The pains are worse when the patient is tilted to the left.It is also a characteristic symptom called a Volkovich symptom. The condition worsens in the case, if you try to bring the right leg to the stomach.

The symptom of Mendel is that when tapping with fingers on the front of the abdomen, the pain is exacerbated in its iliac right side. It turns out to be positive in 80% of cases.

To determine the beginning of peritonitis is carried outsomewhat different diagnosis. Kocher symptom is determined only in the initial stages of the disease. With the development of inflammation, it is no longer observed. If the patient is pressed on the right iliac region and abruptly take away the arm, then the pain increases. This symptom is called the symptom Shchetkina-Blumberg. It is observed in 98% of patients with peritonitis that has begun.

Trace in medicine

The Swiss surgeon Kocher was the first to determine thatinflammation of appendicitis begins with pain in the epigastric region under the xiphoid process. He lived in the XIX-early XX century. It was in his honor that this sign of the onset of inflammation of the cecum process was named.

Kocher symptom occurs during exacerbationappendicitis. Therefore, timely diagnosis is so important. The transfer of pain from the epigastric to the right iliac region is called the Kocher-Volkovich symptom.

But in honor of this surgeon was named not onlyindicated feature. Also known among endocrinologists is Kocher symptom. It lies in the fact that when looking upward, the movement of the eyeball lags behind the speed of movement of the upper eyelid. At the same time between the edge of the iris and the upper skin fold becomes visible sclera. This is a sign of toxic diffuse goiter.

Kocher is also known as the inventor of a numberspecial surgical instruments. So, for example, clamps for vessels, stomach, probes, through which operations on the digestive organs are carried out, drainage tubes made of glass are used by modern doctors.