Appendicesappendix, lat. appendix vermiformis-vermiform Appendix, 5-7 cm in length (sometimes 20 cm), 1 cm in diameter, blindly ending, tube-shaped.
Exacerbation of appendicitis can occur at any age. Risk groups are children older than 5 years, adults 20-30 years, pregnant women. Pathology is equally characteristic of the female and male. Very rarely appendicitis in young children, due to age-related anatomical peculiarity of the Appendix, which has a funnel shape and is easily emptied, and poor development of the lymphoid apparatus process.
Among all diseases of the abdominal cavity, which require urgent surgery, appendicitis is the most common. If there was an attack of acute appendicitis, you need to call an ambulance as soon as possible. If appendicitis is not treated, peritonitis can develop-a complication that leads to a fatal outcome.
How appendicitis manifests, the symptoms and signs of this urgent condition should be known by everyone. The main symptom of appendicitis in adults and children is pain. It occurs in the upper abdomen or near the navel, sometimes it is impossible to specify the exact location of the pain ("the whole stomach hurts"). The pain then moves to the right side of the abdomen. This migration of pain is considered a very specific sign of the disease
Causes of appendicitis
There are the following causes of inflammation of the Appendix:
The combination of mechanical blockage of the Appendix lumen and activation of intestinal microflora. Blockage can cause fecal stones, enlarged lymphoid follicles, foreign body (accidentally swallowed), tumor formation, accumulation of parasites. In the place of appearance of such a "plug" there is an accumulation of mucus, microorganisms actively multiply. Inside the lumen, the pressure increases, the vessels are squeezed, the outflow of blood and lymph is disturbed. The result: inflammation and necrosis of the Appendix.
According to some reports, the risk of appendicitis is higher in people suffering from delayed stool for many years. Due to the slow progress of feces in the digestive tract, such people often appear fecal stones.
The same can be said about those people whose diet is rich in protein and poor in plant fiber. Fiber facilitates the promotion of intestinal contents, improves peristalsis.
Vascular theory suggests that systemic vasculitis (vasculitis – inflammation of the vascular wall) is the cause of appendicitis.
The infectious theory has never been confirmed or disproved. It is believed that some infectious diseases (for example, typhoid fever) can independently provoke the development of appendicitis.
Which side is appendicitis?
The Appendix is a small process of the cecum. In most people, it is located in the right side of the abdomen, below the navel. On which side appendicitis in humans can affect the state of the intestine. If appendiceal peritonitis has developed, the symptoms are pronounced brightly and acutely, the localization of appendicitis pain is usually on the right side, this is typical for the development of acute inflammatory process in the patient's body, which requires urgent medical care and surgery to remove the Appendix.
Appendicitis can be differently located in the peritoneum, which gives a mixed picture in the localization of symptoms, pain can give both to the right side and to the lumbar region, or to the pelvic area, the genitals of the patient. The nature of pain has a different intensity, amplifying or subsiding, cramping, can last as a long time or briefly.
Signs of appendicitis
There are many different signs of appendicitis in adults and children. The signal onset of the disease is severe pain. In the beginning, it does not have a relatively clear location. A person may think that he just has a stomach ache. However, after 4-5 hours, the pain concentrates closer to the right iliac region.
It is worth noting that the Appendix in different people can be located in different ways, it all depends on the structure of the body. If the process has a normal position, the pain will be observed in the right iliac region. If the process is somewhat higher, the pain will be on the right under the ribs. Well, if the process is lowered down, it will hurt in the pelvis. Among other things, the patient may be disturbed and vomiting, and in some cases diarrhea.
Other popular signs of appendicitis include the following: dry tongue, dark urine, fever, which can reach 40 degrees, pregnant women may experience increased pain during the turn from the left side to the right.
Symptoms of appendicitis
signs of Appendicitis in the case of acute appendicitis, symptoms are pronounced. There is an attack of pain in the right iliac region, expressed by the local and General reaction of the body. As a rule, pain in acute appendicitis begins suddenly.
At the beginning of the attack, they are often localized in the epigastric region, in the navel or throughout the abdomen, and after a few hours (sometimes 1-2 days.)- in the right iliac region. Often the pain is of a permanent nature, not radiating to anywhere, but are aggravated by the cough. Abdominal pain does not allow the patient to sleep, but its intensity is usually low; characterized by a decrease in pain in the position on the right side.
In the first hours of the disease, nausea and vomiting may occur. Stool and gas are often delayed. Much less frequent are liquid bowel movements (mainly in severe intoxication). Body temperature rises to 37.5-38°, rarely remains normal. Pulse in the first day from the beginning of the disease is more frequent to 90-100 beats per 1 min, blood PRESSURE does not change and only in severe intoxication is somewhat reduced. The tongue is at first slightly coated and moist, but soon becomes dry.
So same under appendicitis there is and other symptoms. For example, when examining the abdomen, the breathing lag of the lower abdominal wall is often determined. Palpation of the abdomen should be performed carefully, since the left half. In this case, in the right iliac region, as a rule, there is a sharp pain, combined with protective tension of the abdominal wall muscles in a limited area. In most patients, light tapping of fingers in different parts of the abdominal wall helps to quickly establish the place of greatest pain.
However, not always the symptoms and course of acute appendicitis are so characteristic. Especially peculiar may be the clinical picture of the disease in children, the elderly and senile, as well as atypical location of the Appendix. In any case, if symptoms similar to appendicitis occur, an ambulance should be called.
Chronic appendicitis occurs with aching dull pain in the right iliac region, which can periodically increase, especially with physical stress.
Signs of appendicitis in women
To inflammation of appendicitis slopes more women than men, whose symptoms appear more often at the age of twenty, forty years. This is due to the physiological structure of the female body, the pelvis, so it can proceed differently. Especially different symptoms of appendicitis in women during pregnancy. Since the Appendix is located near the right appendages of the uterus, signs of inflammation are twice as common as in the male population.
When palpation in women there are painful sensations, which indicates inflammation of the abdominal cavity.
If you press the point below the navel of a woman, then there may be pain, which will increase when you stand up, which indicates the involvement of the reproductive organs in the inflammatory process.
When examining the vagina of a woman, pain is detected, especially when examining the cervix, appendicitis indicates inflammation of the appendages.
When diagnosing and diagnosing a woman, not only the state of the vermiform Appendix is checked, but the state of the genital organs as a whole.
Diagnostics
The diagnosis is based on the characteristic symptoms of appendicitis. Confirm the diagnosis of "inflammatory signals" the General analysis of blood. The most reliable method is laparoscopy.
Clarification of the morphological form of appendicitis (catarrhal, gangrenous, phlegmonous) is possible with surgical intervention: histological examination of the removed Appendix is carried out. Among the instrumental methods used ultrasound, radiography of the abdominal cavity, irrigoscopy, computed tomography.
inflamed Appendicitis
Treatment
The common tactic in acute appendicitis is the earliest possible surgical removal of the inflamed Appendix. After 36 hours from the onset of the first symptoms, the probability of perforation (rupture) of the Appendix is 16-36% and increases by 5% every subsequent 12 hours. Therefore, after confirmation of the diagnosis, the operation should be performed without undue delay.
At the stage of prehospital care in case of suspicion of acute appendicitis, bed rest, exclusion of liquid and food intake, applying cold to the right iliac region are shown. It is strictly forbidden to take laxatives, the use of hot water bottles, the introduction of analgesics until the final diagnosis.
Currently, with a simple form of appendicitis, laparoscopic operations that do not require an abdominal wall incision are preferred. In this case, the endoscopic instrument is inserted into the abdominal cavity through a small puncture in the tissues. Appendicitis removal in this way avoids surgical trauma, and reduce the recovery period at times. The risk of postoperative complications during appendicitis removal by laparoscopic method is minimal.