Appendix, lat. appendix vermiformis - a worm-shaped process, 5-7 cm in length (sometimes 20 cm), 1 cm in diameter, blindly ending, tubular shape.
Aggravation of appendicitis can occur at any age. Risk groups are children over 5 years old, adults 20-30 years old, pregnant women. Pathology is equally characteristic of the female and male sex. Very rarely, appendicitis occurs in young children, which is explained by the age-related anatomical feature of the appendix, which has the shape of a funnel and is easily emptied, and the weak development of the lymphoid apparatus of the process.
Among all diseases of the abdominal organs, which require urgent surgical intervention, appendicitis is the most common. If there was an attack of acute appendicitis, you need to call an ambulance crew as soon as possible. If appendicitis is not treated, peritonitis can develop - a complication that leads to death.
How appendicitis manifests, the symptoms and signs of this emergency should be known to 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 not possible to accurately indicate the place of pain ("the whole stomach hurts"). Then the pain moves to the right side of the abdomen. This migration of pain is considered a very specific symptom of the disease.
Causes of Appendicitis
There are the following reasons for the development of inflammation of the appendix:
- The combination of mechanical blockage of the lumen of the appendix and activation of the intestinal microflora. Fecal stones, enlarged lymphoid follicles, a foreign body (accidentally swallowed), a tumor, and an accumulation of parasites can cause a blockage. In the place of occurrence of such a "plug" accumulation of mucus occurs, microorganisms actively proliferate. Inside the lumen, the pressure rises, the vessels are compressed, the outflow of blood and lymph is disturbed. Result: inflammation and necrosis of the appendix.
- According to some reports, the risk of appendicitis is higher in individuals suffering from stool retention for many years. Due to the slow movement of fecal masses through the digestive tract, such people are more likely to have fecal stones.
- The same can be said about those people whose diets are saturated with protein food and poor in plant fiber. Fiber facilitates the promotion of intestinal contents, improves peristalsis.
- Vascular theory suggests that the cause of appendicitis is systemic vasculitis (vasculitis - inflammation of the vascular wall).
- Infectious theory has not received any confirmation or refutation. It is believed that some infectious diseases (for example, typhoid fever) can independently trigger the development of appendicitis.
Which side is appendicitis?
An appendix is a small process of the cecum. For most people, it is located on the right side of the abdomen, below the navel. On which side appendicitis a person can be affected by the intestinal condition. If appendicular peritonitis develops, the symptoms are pronounced and acute, localization of appendicitis pains is usually on the right side, this is typical for the development of acute inflammatory process in the patient's body, which requires emergency medical care and an appendix removal operation.
Appendicitis can be differently located in the peritoneal region, which does not give an unambiguous picture in the localization of symptoms, pain can be given both to the right side and to the lumbar region, or to the pelvic area, the patient's genitals. The nature of pain has a different intensity, intensifying or subsiding, cramping, can last for a long time or for a short time.
Signs of appendicitis
There are many different signs of appendicitis in adults and children. Signal is the beginning of the disease is a strong pain. At the very beginning it does not have a relatively clear location. A person may feel that he just has a stomach ache. However, after 4-5 hours, the pain is concentrated closer to the right iliac region.
It should be noted that the appendix in different people may be located differently, it all depends on the structure of the body. If the process has a normal position, then the pain will be observed in the right iliac region. If the appendix is located slightly higher, then the pain will be on the right under the ribs. Well, if the process is down, it will hurt in the pelvic region. In addition, the patient may be disturbed by 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 while turning from the left side to the right.
In the case of acute appendicitis, the symptoms are pronounced. There is an attack of pain in the right iliac region, a pronounced local and general reaction of the body. As a rule, pain in acute appendicitis begins suddenly.
At the beginning of an attack, they are often localized in the epigastric region, in the navel or throughout the abdomen, and after a few hours (sometimes in 1-2 days) in the right iliac region. More often, the pain is permanent, does not radiate anywhere, but intensifies with coughing. The pain in the abdomen does not allow the patient to fall asleep, but its intensity is usually small; characteristic reduction in pain in the position on the right side.
In the early hours of the disease, nausea and vomiting may occur. The chair and gases often linger. Liquid feces are observed much less frequently (mainly with severe intoxication). Body temperature rises to 37.5-38 °, rarely remains normal. The pulse in the first days of the onset of the disease quickens to 90-100 beats per 1 minute, the blood pressure does not change and only decreases slightly with severe intoxication. The tongue is initially slightly coated and wet, but soon becomes dry.
Also with appendicitis, there are other symptoms. For example, when examining the abdomen, they often determine the lag in breathing of the lower abdominal wall. Palpation of the abdomen should be carried out carefully, starting with the left half of it. At the same time, in the right iliac region, as a rule, there is a sharp pain, combined with the protective tension of the muscles of the abdominal wall in a limited area. In most patients, a light tapping of the fingers in different parts of the abdominal wall helps to quickly establish the place of the greatest pain.
However, not always the symptoms and course of acute appendicitis are so characteristic. The clinical picture of the disease in children, the elderly and the elderly, as well as the atypical location of the appendix can be particularly peculiar. In any case, if symptoms of appendicitis appear, it is necessary to call an ambulance.
Chronic appendicitis proceeds with aching dull pains in the right iliac region, which may periodically increase, especially during physical exertion.
Signs of appendicitis in women
To the inflammation of appendicitis, the slopes of more women than men, the symptoms of which 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. Symptoms of appendicitis in women during pregnancy are especially different. Since the appendix is located close to the right appendages of the uterus, signs of inflammation are more common than twice the male population.
- On palpation in women there are painful sensations, which indicates inflammation of the abdominal cavity.
- If you press the point below the navel in a woman, there may be pain, which will intensify when standing up, indicating that the reproductive organs are involved in the inflammatory process.
- When examining the vagina in a woman, pain is detected, especially when examining the cervix, while appendicitis indicates inflammation of the appendages.
When diagnosing and diagnosing a woman, they check not only the condition of the appendix, but the state of the genital organs as a whole.
The diagnosis is made on the basis of the characteristic symptoms of appendicitis. Confirm the diagnosis of "inflammatory signals" of a general blood test. The most reliable method is laparoscopy.
Specification of the morphological form of appendicitis (catarrhal, gangrenous, phlegmonous) is possible with surgical intervention: a histological study of a remote appendix is carried out. From instrumental methods using ultrasound, radiography of the abdominal cavity, irrigoscopy, computed tomography.
A common tactic for acute appendicitis is as soon as possible surgical removal of the inflamed appendix. After 36 hours from the moment the first symptoms appear, the probability of perforation (rupture) of the appendix is 16-36% and increases by 5% every subsequent 12 hours. Therefore, after confirming the diagnosis, the operation should be performed without undue delay.
At the stage of prehospital care in cases of suspected acute appendicitis, bed rest, exclusion of fluid and food intake, application of cold to the right iliac region are shown. It is strictly forbidden to take laxative drugs, the use of hot water bottles, the introduction of analgesics before the final diagnosis.
Currently, with a simple form of appendicitis, laparoscopic surgeries that do not require an abdominal wall incision are preferred. In this case, an endoscopic instrument is inserted into the abdominal cavity through a small puncture in the tissues. Removal of appendicitis in this way allows you to avoid operating injury, and reduce the recovery period at times. The risk of postoperative complications when appendicitis is removed using the laparoscopic method is minimal.
In the case of chronic appendicitis, appendectomy is indicated if persistent pain syndrome is noted, depriving the patient of normal activity. With relatively mild symptoms, a conservative tactic can be applied, including the elimination of constipation, taking antispasmodic drugs, physiotherapy.