Appendicitis is a rather dangerous oneconsequences of the disease. That is why the main task of a specialist is to diagnose him as soon as possible and correctly. A number of symptoms that are named after the researchers who identified them for the first time help to recognize the disease - symptoms of Rovzing, Sitkovsky, Bartome-Michelson, Voskresensky and so on. Let's take a look at them in more detail.
Causes of Appendicitis
There are several causes of appendicitis:
- Occlusion of the entrance to the worm-like end of a straight lineguts - the most common. This can happen due to ingress of foreign bodies, fecal masses. Occlusion may also occur from compression of the upper part of the appendix by the formation of adhesive processes during enteritis and cholecystitis.
- Stagnation of the contents of the process.This leads to a weakening of its protective functions, which is why pathogenic bacteria begin to multiply actively in the appendix - staphylococci, E. coli, streptococci. They cause inflammation.
- Spasm of blood vessels that supply blood to the appendix.
- Trauma to the peritoneum, which can cause movement or damage to the appendix.
- Pregnancy. The appendix may move due to the proliferation of the uterus.
- Tendency to constipation.
- Poor intestinal peristalsis.
- Binge eating.
- Lack of plant fiber, trace elements, vitamins in the diet.
- Diseases of the digestive tract.
- Hereditary factors.
- Infectious diseases.
- The presence of parasites.
- Bad habits.
- Stress.
On the diagnosis of appendicitis in Russia
Appendicitis - inflammation of the appendixrectum. For its initial diagnosis, confirmation or denial of the diagnosis, doctors in Russia use certain symptoms of peritoneal irritation that have been tested for years. They are few, but they are reliable "old-timers" in clinical practice. Named by the name of its author:
- Symptom Sitkovsky.
- Symptom Kocher.
- Symptom Resurrection.
- Symptom Obraztsova.
- Symptom Rovzinga.
- Symptom Shchetkina-Blumberg.
The manifestation of each of them depends on a number of factors: the location of the appendix, the causes of inflammation, disease neglect, and so on. Let us examine the symptom Sitkovsky and others in more detail.
Kocher's symptom
The surest sign by which you canidentify acute appendicitis, is Kocher syndrome. Among physicians, even the expression: "Kocher does not lie." In half of the patients suffering from appendicitis, this symptom was identified.
It manifests itself in the following:pain from the epigastric region gradually migrates to the right iliac. It is determined during the collection of anamnesis, patient survey - clarification of the place of occurrence of pain syndrome, its nature.
Symptom Sitkovsky
When appendicitis, doctors still overwhelmingly prefer this symptom. The main reason is that it can be quickly and easily checked.
Manipulations with the following:the patient is asked to lie on his left side and describe his feelings. With this movement, the intestinal loops are displaced, dragging along the inflamed process. Therefore, the patient in the presence of appendicitis will inevitably complain about the increase in pain.
Symptom Resurrection
Another name is “shirt symptom”.The symptom helps to diagnose not only appendicitis, but also other inflammatory processes of the abdominal cavity. Therefore, in clinical practice, it is popular no less than a symptom of Sitkovsky.
Проверяется следующим образом:on a slightly stretched shirt, which is worn on the patient, is quickly carried by the edge of the palm in several areas in the abdomen. If during these actions the patient feels pain in the right iliac region, then he can be diagnosed with appendicitis.
Symptom Shchetkina-Blumberg
Another sign of peritoneal irritation, not inferior to the Sitkovsky symptom. It is considered a true test for peritonitis, which is why it is used for all complaints of abdominal pain.
The following actions are required:The doctor slowly puts his hand on the anterior abdominal wall of the patient and gently, without effort, presses. Then abruptly removes the hand. If at the same time the patient felt a sharp pain, then the Shchetkin-Blumberg symptom was confirmed. With the acute form of appendicitis, the patient will feel pain during this in the iliac right area.
Symptom Rovzinga
It is rarely used in practice, which is notcancels his loyalty, which is why the symptoms of Rovzing and Sitkovsky are constantly mentioned in the literature. Determined by the appearance of pain with the accumulation of gases in the rectum.
The doctor performs the following manipulations:it is necessary for a reclining patient to squeeze the colon into the left ileal part of the peritoneum. In this case, with the right hand, perform a slightly higher jerky pressure. If with this pressure change in the intestinal tract, the patient feels pain in the iliac right area, then he will be diagnosed with appendicitis.
Symptom Obraztsova
After we told about the symptoms of Rovzing, Sitkovsky, Voskresensky, it would not be superfluous to tell about the Obraztsov sign, which helps to reveal the retrocecal location of the appendix.
The patient is asked to lie on his back and liftstraightened knee right leg. At this time, the musculature of the anterior abdominal cavity and lower back is tightened and begins to act on the receptors of the vermiform process. If the latter is inflamed, the patient will complain of pain in the right iliac region.
Other symptoms
We have examined a number of appendicular symptoms,Sytkovsky symptom. Let us get acquainted with less common, but having in medical practice methods of diagnosing acute inflammation of the vermiform process:
- Symptom Bartome-Michelson. The patient lies on the left side, and the doctor, palpating the right side of the peritoneum, finds a painful place.
- Symptom Varlamov. When tapping in the area of the right XII rib, pain occurs in the characteristic right part of the peritoneum.
- Ben-Asher's symptom. The doctor presses the tips of two fingers intoleft 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.
- Symptom Asaturyana. The doctor pushes the right hand fist on the patient's left iliac region. On the protruding right area with his free hand, the specialist palpates the cecum to localize the pain sensation.
- Symptom Bassler. Soreness is determined by pressing between the upper anterior spine of the Ilium and the navel towards the spine of the bone.
- Symptom Iliescu. Soreness in the characteristic zone occurs when pressing on the cervical point of the right diffractional nerve.
- Symptom Brand. It is used in the diagnosis of appendicitis in pregnant women. When pressing on the left edge of the uterus, pain occurs in the right peritoneum.
- Zatler's syndrome. The patient in a sitting position is asked to straighten the right leg. With an inflammation of the appendix, the patient will feel pain in the right iliac region during this movement.
- Cope's Symptom When the rotation of the right thigh increases pain in the right iliac region.
Consequences of acute appendicitis
Complications of appendicitis are divided into two groups:
- Preoperative. Their reasons are:
- The patient held out with an appeal for medical care.
- The attending physician has incorrectly established the diagnosis.
- The operation was carried out with errors.
- Inflammation has given rise to new diseases or the development of chronic ones.
- Postoperative. Their reasons are:
- Non-compliance with the recommendations of the doctor after surgery.
- Inflammation of the surgical wound.
- Inflammation of the adjacent organs, peritoneum.
Thus, appendicitis is not the most dangerous inflammatory process that can be easily eliminated by surgery. Its terrible complications are terrible:
- Perforation is an early type of complication that develops with a pair of peritonitis. It is characterized as purulent fusion of the walls of the appendix and outpouring of pus into the abdominal cavity.
- Appendicular infiltration - develops in patients who have lately applied for help. This is the spread of inflammation from the process to the neighboring organs.
- Appendic abscess is a rare form of complication. It is a purulent inflammation in the right iliac area, between the intestinal loops, under the diaphragm, in the retroperitoneal space.
- Pylephlebitis - severe purulent-septic inflammation of the hepatic cuspidus, which produces many ulcers. Danger of death.
- Peritonitis - inflammation of the peritoneum.
- Intestinal fistula - a consequence of errors during surgery. This is an accidental defeat of the intestinal loops when an appendix is removed.
We have disassembled, at what disease is observedsymptom Sitkovsky, Obraztsova, Resurrection and so on. As you have seen, with the help of these diagnostics, you can easily and quickly determine the patient's appendicitis.
