Appendicitis (appendicitis) is an inflammatoryprocess of a small vermiform appendage of the cecum called appendix. The word "appendix" in Latin means "appendage", and the ending "itis" indicates inflammation.
According to statistics, among all surgicalof diseases appendicitis according to the frequency of spreading takes about 89% of cases and is in the first place. More often it occurs in people of young able-bodied age from 18 to 35 years. The prevalence of this disease in women is 2 times higher than that of men.
Classification
Appendicitis can occur in acute and chronic form. The acute form is divided into the catarrhal course of the disease and destructive, which, in turn, can take several forms:
- phlegmonous;
- phlegmonous and ulcerative;
- apostematous;
- gangrenous.
Chronic appendicitis are also divided into several forms. He can be:
- residual;
- primary chronic;
- recurrent.
All these forms of chronic appendicitis differsclerotic and atrophic processes occurring in the vermiform appendage. The proliferation of granulation tissue in the walls of the appendix and its lumen can occur, the formation of adhesions between the surrounding serous membranes. In the case of accumulation in the lumen of a vermiform appendage of serous fluid, a cyst develops.
Appendicitis in children and adults: causes, symptoms and treatment
Very often the patient draws pain in the abdomenattention not immediately, but after a few hours or even days. This is due to the fact that the first signs of appendicitis in adults develop gradually and are of an uncertain nature. There are difficulties with the definition of a specific area of pain localization. When taking pain medication, pain can completely subside and be felt only with sudden movements and deep inspiration or coughing.
Appendicitis: signs in adults
- Constant pain, which in the first few hours is localized in the navel, then descends to the right.
- Nausea and vomiting once.
- Raise body temperature to subfebrile.
If such symptoms (signs) of appendicitisadults showed up, then do not hope that everything will dissolve by itself. We need to call an ambulance. An experienced team of doctors will easily identify such a dangerous disease that requires immediate hospitalization, like appendicitis. The signs in adults, as already mentioned, can be blurred. To clarify the diagnosis before the arrival of doctors can conduct self-diagnosis.
This is done as follows:in the lower abdomen on the right, you need to press strongly with two fingers (middle and index), and the pain should not be felt. Then the fingers are removed, and the pain increases sharply. If such a test was positive, i.e. everything turns out as described, besides, nausea may occur, and in some cases, vomiting, then, most likely, these are the first signs of appendicitis in adults. Now let us describe them in more detail.
Symptomatology
With the diagnosis of appendicitis, the signs in adults can be somewhat blurred, but they all boil down to the following:
- First there is pain in the abdomen, which is clearlynot localized It can manifest itself in the navel, epigastrium or have a blurred character (all over the abdomen). The pain is constant, sometimes it can be cramping. After an hour or more, it concentrates in the lower abdomen to the right. This symptom of moving pain is called Kocher-Volchkov. Irradiation of pain is usually not observed. This is only possible with an atypical location of the appendix. In this case, the pain may go to the groin or lumbar region.
- Patients, as a rule, have no appetite. This symptom is called anorexia.
- Following the pain, nausea develops, and there may be a single vomiting. These signs of appendicitis in adults are reflex in nature and develop as a result of peritoneal irritation.
- Subfebrile temperature may rise, but this is not always the case. Signs of acute appendicitis in adults, such as fever, vomiting, and anorexia, are called Murphy’s symptoms.
With the appearance of such signs in a patient cansuspect acute appendicitis. Sometimes these major appendicitis symptoms in adults are accompanied by frequent urination, stool disorders (diarrhea), rapid pulse and, in rare cases, an increase in pressure. Other uncharacteristic symptoms of this disease can be observed in the elderly, children and pregnant women, as well as with the atypical location of the appendix of the cecum. What signs of appendicitis in adults are observed most often, we examined. Now let's talk about the features of the development of this disease in women, and also consider what danger it carries during pregnancy.
Features of the diagnosis of appendicitis in women
The representatives of the fair halfhumanity the probability of error in the diagnosis of this disease is higher than that of men. This is due to the fact that sensations during the development of this disease can be confused with pain during menstruation or a painful reaction when an inflammatory process occurs in the gynecological region of the pelvic organs. This error may occur when the atypical location of the appendix.
To clarify the final diagnosis in the medicalIn addition to the surgeon, the gynecologist should also examine the institution. A distinctive symptom of inflammation of the appendix from the gynecological pathology is the fact that in the latter case vomiting, nausea and upset stool are not characteristic.
Symptoms of appendicitis in pregnant women
The signs of appendicitis in adult women are the samelike men. The exception is pregnant women. According to statistics, the incidence of appendicitis during pregnancy is about 5%. The representative of the beautiful half of humanity, preparing to become a mother, with this disease can be observed atypical form (in case of displacement of the appendix).
Diagnosis of appendicitis during pregnancyusually does not cause difficulties. Symptoms are the same as in other adults. Difficulties may occur in the last trimester of pregnancy, if the nature of the pain is cramping. Patients, as a rule, assume the forced position of the body lying on their backs with their knees bent and their legs pulled up to the belly. The pain is localized most often to the right in the iliac region, but in late pregnancy it can appear higher. Also in the last months of pregnancy, concerns are caused by surgical treatment of appendicitis and the postoperative period of rehabilitation. Therefore, it is extremely important to correctly diagnose.
Causes of appendicitis during pregnancy
This disease arises due to the fact that duringA baby's enlarged uterus can affect the cecum and change its position. Also, the appendix can be impaired by the enlarged uterus, as a result of which the blood supply is disturbed. This sometimes leads to an inflammatory and even gangrenous process. The cause of appendicitis in pregnant women also serves as a change in hormonal levels. During the carrying of a child, women often experience stool disorders, namely constipation, which can also trigger this pathology.
What is dangerous appendicitis during pregnancy?
Очевидно, что любое хирургическое вмешательство, especially when it is performed in the abdomen of a pregnant woman, it can cause miscarriage or premature labor. But besides this, it is dangerous in the following states:
- the development of fetal hypoxia;
- placental abruption and premature fetal aging;
- the occurrence of acute intestinal obstruction;
- postoperative infection;
- violation of the contractile activity of the uterus during childbirth;
- the development of bleeding in the postpartum period.
Thus, we looked at all possible appendicitis symptoms and signs of disease in adults. Now let's pay attention to the features of the development of this disease in children.
Symptoms of appendicitis in older children
Symptoms in children of senior school agesimilar to the signs of this disease in adults. One can only add that such patients often occupy a forced position of the body, at which the intensity of pain decreases. They lie on your back or right side. In addition, the temperature rises to 38 degrees and even higher. Pulse does not correspond to the parameters of increase in body temperature and is highly speeded up
When examining the oral cavity is wetthe language in which there is white bloom. A bad sign is dry tongue. This may indicate the development of gangrenous disease and peritonitis. In children of this age, there may be a delayed stool with this disease.
Symptoms of appendicitis in young children
In children, the signs of the disease being considered may be suspected in the following cases:
- The child is crying and does not allow to inspect.
- The baby pulls the right leg to the stomach and curls up.
- The temperature in small patients with a diagnosis of appendicitis often rises above 38 degrees, can reach up to 40.
- The pulse is frequent and corresponds to an elevated temperature.
- Stool liquid, frequent.
- Urination may be painful and rapid. When urinating baby cries.
- In young children, vomiting can be multiple.
- The child is restless, refuses to eat, cannot sleep, constantly asks to drink.
What signs of appendicitis in adults and children exist, we now know. Consider the possible dangerous consequences of this disease.
Complications
In some cases, the disease is complicated by the following processes:
- abscess of the abdominal cavity, which can be appendicular, subphrenic, interintestinal or Douglas, depending on the site of localization;
- thrombophlebitis of the pelvic or iliac veins, it can be the cause of a very serious condition - pulmonary embolism;
- peritonitis, in case of rupture of the appendix;
- the formation of postoperative infiltration;
- the development of adhesions in the postoperative period, which can provoke intestinal obstruction.
Treatment
If there are signs of inflammation of appendicitisin adults or children, it is shown as soon as possible to make an appendectomy, i.e. removal of the appendix to avoid serious complications of this disease. This operation is carried out on an emergency basis - no later than an hour after the exact diagnosis.
Recommended at the stage of first aidbed rest. It is strictly forbidden to take any food and drink. You can not take painkillers, laxatives and other drugs to clarify the final diagnosis, apply cold or heat.
Once an accurate diagnosis is established“Appendicitis” (signs in adults and children are described above), the patient is placed in the surgical department and an appendectomy is performed. With uncomplicated course, this operation is done with a laparoscopic method.
Then the patient is transferred for several hours.to resuscitation, where he is under constant medical supervision. After the patient finally withdraws from anesthesia, he is transferred to the surgical department. On the 5th day, the sutures are usually removed and the patient is transferred to outpatient treatment.
With a complicated course of this disease, the patient remains in the clinic, and his discharge will be delayed until the undesirable consequences are eliminated and the general condition stabilizes.
Forecast
With an uncomplicated course of the disease and a timely, competently performed operation, appendicitis does not pose a threat to life. The patient’s full working capacity is restored after 4 weeks.
The reasons for the development of complications of appendicitis, as a rule, are untimely hospitalization and delayed surgery. In severe cases, it can even lead to death.
