Appendicitis. Symptoms in adult men. Stage of acute, chronic, abscess, catarrhal, complications, diagnosis, ultrasound, treatment, diet, surgery to remove

Appendicitis - threatening inflammatory condition of the appendix of the cecum, the most frequent surgical diseases of the abdominal cavity. The symptoms of this disease in adult men and women are different because of their physical nature.

The symptoms of appendicitis inflammation in men

The disease occurs in 50 per 10,000 population from different age groups, and is most common in people 20-45 years of age. Male population less than the fairer sex susceptible to inflammation of the appendix, but they are more often ruptures and necrosis.

The main feature of the disease is a pain that comes from the first moments of the inflammatory process. It is of varying intensity. Amplified by coughing, movement, walking. Decreases when there is a person in a fetal position.

Allocate more common symptoms are:

• rise in body temperature, but does not rise above 38C. In rare cases, may remain unchanged until recovery;
• nausea, vomiting (occurring 1 or 2 times) - it appears immediately after episodes of pain. It appears sporadically, depending on the stage of inflammation;
• weakness;
• cardiac arrhythmias;
• diarrhea - if the process is close to the location of the intestines;
• tongue with a white coating;
• frequent urination - if the placement of the appendix near the bladder;
• dry mouth;
• loss of appetite - at first it decreases and then disappears altogether.

On the manifestation of the disease affects a man's age, what stage of the pathology and whether there are other gastrointestinal diseases.

By critical, the most dangerous features include:

1. For several hours utihshaya pain. This suggests that there was a rupture of the inflamed appendix. In the event of a sharp increase in ongoing pain suggests peritonitis.
2. The sharp rise in temperature to 39C or lower to a low level.
3. Frequent vomiting.
4. High abdominal muscle tension.

The distinctive manifestations of disease include the fact that the gentle pressure on the right side of the abdomen egg It pulled up, and it appears an unpleasant painful sensation when slightly pulling scrotum.

Localization and feature of the pain associated with inflammation of the appendix

Appendicitis (symptoms in adult males depend on its localization) is distinguished from other diseases by the presence of pain from the first moment of the inflammatory process. Sometimes it is very strong, forcing a person to move.

Inflammation of the appendix and provoke diseases of the bodies near which it is located:

• at process location male pelvic pain is reflected in the scrotum;
• if it located at the rear of the rectum - occurs in the side of the abdomen or in the lumbar region;
• if the location of the median, it covers the central region;
• podpechonochnom being in space - like biliary colic.

Despite the typical location of the appendix, pain attacks at the beginning of the disease spread throughout the abdomen, in half the cases is localized near the stomach. And only through 5h stops in the right iliac region (Kocher-Volkovich Syndrome). In such cases, you can not take pain medicine.

For the correct diagnosis doctor examines a variety of ways on the basis of pain, watching these symptoms:

1. Bartome-Michelson - examine the abdomen men light hand pressure. The pain increases to the right.
2. Resurrection - Doctor holds over a shirt from epigastric part of the right side. Increase in pain attacks in the abdomen.
3. Obraztsova - lying on your back and lifting your right leg.
4. Rovzinga - a pressure-sensitive pads pushes the fingers on one hand, there is an increase in pain on the other.
5. Sitkovskiy - strengthening of unpleasant sensations in the position on the left side.

At various stages of the inflammatory process, the nature of pain is different.

Kinds of appendicitis in men

Types inflamed appendicitis depends on the strength and duration of the vascular spasm. Changes in the flora of the appendix also affect the determination of the form of the disease. Originally divided into two types - acute and chronic.

First, in turn, can be:

• catarrhal - it has a weak inflammatory changes, applies only to the mucosa of the appendix. Mild symptoms are. Is its swelling. Development lasts 6 hours after the first signs;
• phlegmonous - irreversible processes are distributed throughout the appendix, there is pus sores. It lasts at timing after 7 hours and up to 24h;
• gangrenous - begin to die and the tissue of the appendix inflammatory process advances to bodies that are close to him. It may take this phenomenon up to 3 days;
• ruptured - represents the greatest danger to human life. The walls of perforated appendicitis appear cracks through which the abdominal cavity its content falls. This is the cause of peritonitis. When this degree possibly fatal disease.

Chronic appendicitis develops after acute or as an independent pathology. The process of its long.

In any form of appendix inflammation requires immediate hospitalization for an accurate diagnosis. The treatment is carried out at any stage solely by surgery.

Acute catarrh process

Catarrhal inflammation of the appendix with its mucous membrane morphological changes is the most common surgical pathology (90%). At the age of 12 to 25 years, males are hospitalized more often than women.

The causes of this disease are not fully understood. Although adhere to these versions of the possible ways of occurrence:

1. Mechanical - is partitioned out of the process of the spikes, fecal stones. Increased pressure within it, and starts the inflammatory process.
2. Infectious - due to exposure to infections inside the body.
3. Allergic - reducing the protective function leads to inflammation.
4. Vascular - affects the blood vessels of appendicitis.
5. alimentary - violation of the passage of food through the digestive tract in the case of small consumption of fiber in the food.

Appendicitis (symptoms in adult males can easily be confused with other bowel diseases) catarrhal difficult to correctly identify even an experienced surgeon. What matters is the location of the process, the individual characteristics of the organism.

Doctors at diagnosis pay attention to these signs:

• body temperature - rises to 37,1S;
• if there is constipation or diarrhea;
• the presence of weakness;
• vomiting;
• pain - the main landmark. Deployed in the umbilical area or right side. Is aching in nature.

State men with catarrhal appendicitis satisfactory. When diagnosing a common examination, ultrasound. Blood tests, the results of which indicate increased number of leukocytes. Under the supervision of the surgical department of the patient is about 6 hours.

surface appendicitis

A superficial appendicitis inflammation moves inside it further. It is distributed not only on the mucous membrane process, and already on the fabric. There is a violation of lymph due to failures in the vessels.

From such an impact on inflammation body, one feels the pain more. It appears most often in the right side, it does not extend to adjacent organs of the peritoneum. Symptoms added feeling of intoxication.

About 75% of cases the disease is detected at this stage.

Acute inflammation of the appendix abscess views

Appendicitis (symptoms in adult males 12-24 hours amplify) the next step is called acute inflammation abscess. Characterized by the appearance in it of edema, an accumulation of pus. On the surface of fibrin deposited film process. If the outflow is closed in a process, it resembles the shape of the bulb.

In complex cases, the sprout are formed ulcers and erosions. In this form of appendicitis inflammation greatly increases in size, its walls become transparent. The inflammatory process is almost always goes to the surrounding tissue.

At this stage, symptoms such:

• Pain - a continuous, very severe, throbbing.
• Body temperature - rises to 38,5S.
• Nausea - is present, but without retching.
• Pulse - rapid, up to 90 times per second.

The patient's condition deteriorates significantly, it has a pale appearance, it throws into the pot. On examination the doctor observes a tense abdomen. There are cases when the process is very long and is located in the pelvic part of the body. Then the pain is felt above the pubis or in the groin area to the right. Very rarely shifted to the left side due to the reversal of internal organs.

Appendicitis determine when a diagnosis of a doctor is not hard. Symptoms pronounced in adult males, also helps to identify the disease blood test result.

Inflammation of the peritoneum in phlegmonous inflammation occurs always. However, the walls of the other organs is blocked. Peritonitis is rare, only in very debilitated patients (5-8%).

Gangrenous acute appendicitis

Appendicitis (symptoms in adult men often talk about the severe form of the disease) occurs in gangrenous if the time was not detected and surgically removed.

It occurs in 2-3 days after the onset of the inflammatory process. It occurs due to impaired blood flow within the process.

Death of tissue in this form leads to necrosis of nerve endings. Therefore, there is no pain. However, the inflammation spreads further, the entire abdominal cavity. The man there is a weakness, repeated vomiting.

The temperature may not rise, so it is a reference point for the exact diagnosis does not happen. Language is often dry, with white fur at the root. Heartbeat reaches up to 120 beats per minute (normal 70-80). The belly is very painful and stressful.

When gangrenous acute appendicitis, there is a huge risk to human life. Appendix in a fevered state can overstrain or appear in it opening. It has come gangrenous-performative stage. There is a sharp pain that spreads throughout the abdomen. This form of inflammation has an even greater danger to the patient.

Urgent removal organ. Otherwise, the infection of the blood that leads to death.

Hardware, laboratory diagnostics and medical examination

In identifying acute appendicitis occurs a lot of mistakes, because his clinical picture is very similar to other diseases (liver, kidney, intestines). Therefore, the doctor uses all possible ways to diagnose.

In laboratory research for more accurate diagnosis of conduct blood and urine analysis. When inflammatory leukocytes in the blood will always be raised. But its biochemical composition does not change. But with peritonitis and postoperative complications such analysis is required to conduct. Red blood cells in urine increased, if the appendix is ​​located near the bladder.

During surgery conducted bacteriological research. From peritoneal exudate taken for culture, and in his absence, the foundations of the visceral process.

By instrumental methods for the determination of the disease include:

way of	Function
X-rays of the abdomen	Spending is not always necessary, but it helps to reveal the presence of fecal stone in a process, as well as other causes of the destruction of its walls.
CT scan	Advantageously carried out at a well-manifested signs of complications.
Ultrasonography	Gives a lot of useful information, 95% of patients with ultrasound raised an accurate diagnosis. This is facilitated by the presence of fluid in the abdominal cavity, the size increase process, thickening its wall.

On examination, the doctor carries out a differential diagnosis, excluding the possibility of other diseases. He draws attention to the general condition of the patient (fatigue, nausea, vomiting), pain.

For a survey of the man lies on his back and hands the surgeon probes stomach starts to do it on the left side.

Effective are these symptoms:

• Shchetkina-Blyumgera -plavno pressed against the peritoneal wall, and then are released with 2;
• Horne - when you pull behind the scrotum, there are pain in the right testicle;
• Britten - with abdominal palpation shrinks egg;
• Larock - when checking belly hands in front, right testicle is pulled. Sometimes it happens spontaneously.

Diagnose must only qualified personnel in a medical facility. Attempts to test the stomach may itself lead to rupture of appendicitis.

Preparation for surgery

After entering the patient unit and inspection (if the diagnosis is confirmed by an inflammation of the appendix) man prepared for surgery. In the case of doubt about the patient's disease is left in the hospital for observation.

The only one known medical treatment of acute appendicitis is its surgical removal (appendectomy).

Sometimes it is of two kinds:

1. open - going through an incision in the abdominal cavity. Spend it using general or local anesthesia. In case of complications, this method effective. When there are gaps process, do not make the cut on the right side, and the bottom and middle of the abdomen.

   

2. Laparoscopy - Allows you to diagnose the disease and carry out the operation. Puncture is made in the abdominal wall through which the device is introduced with the video camera on the end. And in confirming the diagnosis and need for removal process, make another 3 puncture. It is advisable to use this method if the patient has been some time, and establish an accurate diagnosis is very difficult. And in the case of overweight men.

After laparoscopy wounds heal quickly, scars are left. Before the start of its operation the anesthesiologist must obtain the necessary information about the patient. To do this, is conducting a study of the cardiovascular system, learns about the potential for allergic reactions of the body man.

Prepare the surgical site as follows:

• treatment of abdominal skin;
• shaving the hair sections;
• defatting and disinfection of the operative field region.

Before the operation the doctor conducts a conversation with the patient and his relatives about how the impact of surgical anesthesia, possible complications.

Features of the postoperative period

Recovery (postoperative) period is counted from the end of surgery to remove the operating seams. On the first day after the procedure, appendectomy, if necessary, carry out detoxification of the body, give the patient to drink.

Are monitoring the condition of the patient, that there was no bleeding. From 2 to 10 days following:

• the restoration of the independent exercise of physiological functions (urination, defecation);
• body temperature;
• presence of pain;
• the state of the joints.

In a hospital patient holds up to 10 days, if you do not have any complications. It allows the doctor to go on day 3. Power is allowed for 2 hours. It should be dietary.

Sutures with classical operation takes about 3-7 cm. healing rate depends on the quality of the overlay. Remove them after the appearance of the crust. It usually occurs on day 7.

rehabilitation dates

To restore the entire person needs about 1.5 months at adherence and regular visits to the doctor. The first week the patient spends in the hospital. Timelines optionally stick. Everything depends on the characteristics of the organism. Young and slim man rehabilitated after surgery faster.

For a complete successful recovery recommend:

1. Use bandage.
2. Sex only after 2 weeks.
3. Explore on foot.
4. Do physical exercises.

As well as the human diet should consist of easily digestible food. In the first days after the removal of the appendix is ​​recommended mashed foods, cereals, soups.

Next 2 months it is advisable to use:

• warm food;
• abandon the products that cause fermentation, swelling of the digestive tract;
• eat frequently but in small portions;
• diet enriched foods rich in vitamins and minerals;
• enter into the diet of non-nutritive food.

In cases where complications arise before or after surgery rehabilitation periods are individual.

possible complications

complications can arise when late of medical care. They are divided into early (3-7 days) and late (after 10 days).

Among the former are as follows:

• Bleeding - if the transaction took place on large vessels.
• Paleness, shortness of breath - occurs in severe pain.
• Paralytic ileus intestine.
• Peritonitis.
• Pneumonia.
• Heart failure.
• Divergence wounds.
• Vomiting.
• Sepsis - Poor treatment of wounds.
• Thrombophlebitis.

Late complications of note are:

• postoperative hernia - entering the intestine between the muscle fibers. Most often occur after heavy loads. Or removed surgically sutured;
• adhesions - there is a nagging pain and discomfort. It is difficult to determine their availability, since it is not visible on ultrasound and X-ray. Treated absorbable drugs;
• fistulas - appear between the intestine and the skin (other bodies). The reason becomes substandard appendectomy, the inflammatory process bodies located near the ridge. Difficult to treat. Remove the affected area.

The causes of complications include:

• Later, access to a doctor.
• Medical errors during the operation.
• Chronic diseases of neighboring organs.
• Untimely diagnosis.
• Ignoring the advice of the doctor patient.

One of the most dangerous diseases is surgical appendicitis. Ignore the symptoms, you should not, as at untimely treatment of possible irreversible consequences. Though adult male on Statistics disease is rarer still to seek help from a doctor is necessary.

Registration of the article: Vladimir the Great

Video of the inflammation of the appendix

How to recognize the first signs of appendicitis: