Acute appendicitis - this emergency surgical pathology, which is manifested by inflammation of the appendix in the area (appendix blind intestine).
Acute appendicitis is manifested by pain in the abdomen, nausea and impaired general condition. Require immediate surgery to remove it, late diagnosis can cause serious complications, including death.
Causes
The appendix is a lymphoid organ, it is concentrated a large number of immune cells, it helps to carry out the immune defenses of the digestive system. The appendix has an average length to 5-6cm, thickness of 1 cm. Scion may be located in both the classical position, stepping down from the gut in the right iliac bone, and lie in other directions. This is important in the diagnosis of appendicitis manifestations.
The reasons for the inflammation of the appendix is enough:
- blockage of his thick feces,
- occlusion of dense fragments of food (bones, seeds, thick pieces of food)
- tissue growth,
- increase in lymphoid areas of lymph nodes with occlusion of the lumen,
- thrombosis,
- allergy,
- intestinal infection
- It is on a rigid diet, poor nutrition,
- genetic predisposition, stress, bad habits,
- the transition from infection to other organs (in women - with the pelvic organs).
kinds of appendicitis
By duration and severity of the process is isolated and chronic acute appendicitis.
Acute appendicitis, based on the stage of the process and the duration of the flow is divided into:
- catarrhal stage, it lasts for the first 6 hours
- Phlegmonous step, it lasts until the end of the first day,
- gangrenosum step, the duration until the end of 3 days,
- perforation of the appendix and peritonitisIt characterized by rupture or melting walls and the output contents into the peritoneal cavity with the formation of peritonitis.
Symptoms of acute appendicitis
The disease has a clear staging, and the severity of it depends on the duration of inflammation, however, it can only identify the surgeon.
For the patient, it is important to identify the danger signs that would indicate acute appendicitis. These include:
1. The first signs of appendicitis:
- pain in the stomach or podlozhechkoy, around the navel or diffuse character,
- pain gradually over 3 hours flow into the right side, in the region of the ilium.
- pain severe, are activated when standing up and walking, lying on his left side.
- in position on the right side, the pain decreases.
2. The occurrence of pain in the evening or at night, sometimes in the morning
3. Against the background of pain occur nausea and the slim, single vomiting, may be diarrhea or constipation.
4. Against the background of the pain gradually increases the temperature, the condition worsens, there are lethargy, bright eyes, paleness, coated tongue.
Even in the absence of all symptoms described except abdominal pain if it lasts for more than 4-6 hours, and inspection require hospitalization surgeon.
Age-related symptoms of appendicitis
- Children: a rapid increase in the manifestations. Body temperature is often high. vomiting and diarrhea more pronounced. Early return to full physical activity regime.
- Elderly: effacement appendicitis manifestations may be a cause of delayed diagnosis and hospitalization.
- Pregnant:.. Diagnosis is difficult, that the appendix to the shifted upward pregnant uterus, leading to typical pain change location, and its location behind the uterus - to decrease the severity of symptoms of irritation peritoneum. Intrauterine fetal death occurs in 2-8,5% of cases.
Diagnostics
Despite all medical advances are not always easy to diagnose acute appendicitis. He is made up of:
- complaints and typical onset of the disease,
- Data inspection and detection of specific symptoms of abdominal palpation,
- Data Express blood and urine tests,
- additional tool data (ultrasound, X-rays, diagnostic laparoscopy).
In a typical arrangement of the appendix usually diagnosis is established quickly, but it needs to be distinguished by its atypical localization of:
- ileus,
- stomach ulcers and 12 duodenal ulcer,
- diverticulitis,
- cholecystitis and pancreatitis,
- acute inflammation of the appendages and ovarian apoplexy among women,
- pyelonephritis, renal colic.
Diagnosis should be engaged only surgeon in the emergency department of surgical hospital for women and girls is obligatory consultation of the gynecologist.
First aid for acute appendicitis
For appendicitis is very important to give first aid to further not lubricate the clinical picture and complicate diagnosis.
When the pain can take antispasmodics - Nospanum or papaverine, no more than 2 tablets, and only 1 time. Next, you must appeal to the surgeon or call the ambulance.
Absolutely forbidden:
- dipyrone and its application containing preparations
- ketorol use, nimesulide or NSAIDs (Nurofen, indomethacin).
- applying heat to the stomach, warmers, compresses,
- use of laxatives, enemas, folk remedies,
- antibiotics and intestinal antiseptics (nifuroxazide).
therapies
Today, the only treatment for acute appendicitis is surgery to remove the appendix - an appendectomy. It is carried out by two methods:
- classic operation with slits,
- laparoscopy with punctures the abdominal wall and the removal process manipulators by visual inspection.
The operation was carried out in a matter of urgency, after 1-2 hours of pre-emergency preparation - blood and urine tests, inspection and survey of patients with allergies and identifying problems health.
The operation is performed under general anesthesia, it takes from half an hour to several hours depending on the severity and complications.
In uncomplicated cases, preference is given to laparoscopy. After her almost no seams and recovery is faster. For suspected gangrenosum shape and a perforation may apply classic and extended operation.
After the first day of operation shown strict bed rest and light power gradually expanded mode. Stitches are removed after a week, the extract in the range of 5-10 days.
Read more about the diet after the acute appendicitis - in our a separate article.
Complications of acute appendicitis
Appendicitis - an insidious disease that often gives serious complications. These include
- abscesses in the appendix, or in the peritoneal cavity,
- the development purulent peritonitis, adhesive processes,
- forming appendicular infiltrate the impossibility of an appendix removal without injury to adjacent organs.
They can also develop inflammation in the vascular field, vein thrombosis extending from the appendix. Such complications can disrupt the function of the liver and even cause death.
prevention
Methods of specific prevention of acute appendicitis has not been developed. You need proper nutrition, rational mode and prompt recourse to a doctor if you experience abdominal pain.
