The appendix size varies from 5 to 15 centimeters in length, its diameter is about one centimeter. Appendix performs the function of protecting the small intestine from microbes that live in the caecum. Appendicitis is the suppuration of the appendix. This disease of the abdominal cavity manifests itself quite often and almost always requires surgical treatment.
There are two forms of appendicitis – chronic (very rare, many scientists generally do not allow the possibility of its development) and acute appendicitis. Acute appendicitis can give serious complications, including peritonitis, intestinal obstruction and even sepsis. The main symptom of appendicitis is pain – an attack of pain in the case of acute appendicitis occurs suddenly.
Appendicitis is a fairly common disease.
It can manifest itself at any age. However, it is known that it is most common in people between the ages of ten and thirty. The incidence of acute appendicitis is four to five cases per thousand people per year. It is appendicitis that occupies a leading place among diseases of the abdominal cavity, requiring surgical treatment (this disease accounts for almost 90% of cases). Most often, acute appendicitis leads to the development of peritonitis.
Appendicitis is an inflammation of the appendix.
It is believed that this disease begins after a hole is clogged between the cecum and the appendix. The cause of blockage can be either the ingestion of stool from the cecum into the process or in the layering inside the appendix of thick mucus – the mucus or stool solidifies, resulting in blockage of the hole (the stones formed in this way are called coloring). Another cause is blockage of lymphoid tissue as a result of swollen lymphoid tissue. Finally, appendicitis can be associated with rupture of the appendix, the cause of which is often unclear. Perhaps the gap occurs as a result of changes in the lymphoid tissue that lining the inner surface of the appendix.
Pain is the main symptom of appendicitis.
Pain covers the entire abdomen, but is more troublesome at the top of it. A characteristic feature is the fact that pain with appendicitis does not have a clear localization, that is, the patient can not accurately show the place where it hurts – in this case it is a question of indistinctly localized pain. As the suppuration of the appendix increases, it can spread to the peritoneum (through the abdomen) – in this case the pain tends to increase. The patient can already more or less accurately say where the pain is localized. However, if the appendix bursts and the inner film of the stomach is infected, the pain can not be localized again. Other possible symptoms of this disease include nausea and vomiting, fever. The latter phenomenon is normal. Because it means that the body began to fight infection.
The attack of acute appendicitis begins suddenly.
Most often it is just like that. Pain appears unexpectedly. At the beginning of the attack, vomiting often occurs, which, however, does not bring any relief; the usual phenomenon is stool retention (by the way, in case of suspicion of acute appendicitis, laxatives and enemas should not be used, as all this can lead to peritonitis). An attack of acute appendicitis is characterized by an increase in temperature of 37.5-38 ° C. The blood test in most cases shows the presence of leukocytosis in the blood, if necessary, a second blood test is performed – two to four hours after the first analysis. In the initial period of the disease, ESR, as a rule, is normal, but in the subsequent time it is usually increased.
Symptoms of appendicitis may disappear.
This occurs when the inflammation does not cover the abdominal cavity. To create such a situation can, for example, take antibiotics (but not necessarily).As a result (the disease does not go anywhere), patients can apply to medical institutions after a rather long time after the attack of appendicitis. They may have an infiltration or swelling in the right lower abdomen.
Chronic appendicitis is rare.
The main complaints of patients are associated with the presence of recurring pain in the right iliac region. This disease is diagnosed on the basis of a comprehensive planned examination (its purpose is to exclude all other diseases of the abdominal cavity and kidneys), as well as on the basis of data of anamnesis. The latter in this case includes information about a previous attack of acute appendicitis and the formation of an infiltrate.
Diagnosing chronic appendicitis is especially difficult in childhood.
Diagnosis is carried out only under stationary conditions. This is due to the fact that pain can appear as a result of not appendicitis, but with malformations, inflammation of the mesenteric lymph nodes, and also for other reasons. If a carefully conducted examination has confirmed the diagnosis of appendicitis, then its treatment is prompt.
Diagnosis of acute appendicitis in children is difficult.
Especially for children under three years old. In childhood, the clinical picture is approximately the same for all acute inflammatory diseases. The course of acute appendicitis in children is much more difficult than in adults. Interesting statistics on diseases of acute appendicitis. Young children account for approximately 5% of acute appendicitis, 13% of acute appendicitis for preschool children and over 80% for school-age children.
Appendicitis presents the greatest danger in pregnancy.
This disease is the most common cause of surgical treatment in pregnant women. One case of acute appendicitis occurs in 700-2000 pregnant women. Complexity consists in the timely diagnosis of this disease in pregnant women. Complexity is due to the physiological and anatomical features of the female body during pregnancy – as a result, appendicitis gives complications. Early apandectomy in this case can save the life of the mother and child and prevent the development of complications. The main symptoms of acute appendicitis in pregnant women is acute pain. After a while, the pain begins to be aching. In this case, it has a more precise localization – that is, the pain moves to the right lateral part of the abdomen.
Acute appendicitis can be recognized by testing many symptoms.
As a result, a clear clinical picture emerges. Here are some of the symptoms. The basis of Pshevalsky’s symptom is the emergence of difficulty in a patient with acute appendicitis in raising his right leg.
Rizvan’s symptom is to increase pain in the lower right abdominal area while performing a deep inspiration. The sign of the roving is related to the fact that when the sigmoid colon is squeezed, the pain either appears (if it did not exist) or tends to increase (if it existed). The symptom of Shchetkin-Blumberg is positive if the pain increases with a sharp ablation of the hand. Symptom Sitkovsky is that the patient, lying on his left side, feels the occurrence of pain in the right ileal region (if they did not exist before) or their amplification.
Diagnosis of acute appendicitis can be complicated due to the fact that the appendix in different people has its own peculiarities of location. If the appendix is located retrozekalno – that is behind the cecum – then the stomach continues to be soft; in accordance with the above, it is difficult to diagnose acute appendicitis. Therefore, there is a need to examine the organs of the chest cavity.
Women undergo gynecological examination. The latter, along with rectal examination is very important, as the diseases of the pelvic organs have a similar clinical picture with acute appendicitis.And only eliminating the disease of the small pelvis, you can talk about acute appendicitis.
Acute appendicitis is subject to surgical treatment.
Diagnosis of this disease serves as an indication for an emergency operation. If there are no symptoms of diffuse peritonitis, then the McBurney cut is performed. In the domestic science it is called the access of Volkovich-Dyakonov. The main stage of the operation is to remove the appendix. Now widespread laparoscopic appendectomy. Its essence is to remove the vermiform appendage through small punctures of the abdominal wall. Punctures (most often three) are done with the help of special tools. It should be noted that surgical treatment is performed if there is no evidence of an appendicular infiltrate. If signs of a formed infiltrate are present, the patient is assigned a bed rest, a diet corresponding to the disease, and antibiotics are prescribed. If the size of the infiltrate increases, then surgical treatment is necessary. It consists of an autopsy.
If you do not diagnose appendicitis in time, then it threatens with serious complications.
Peritonitis is one of such complications. The perforation of the appendix is a very common complication. In this case, the infection from the appendix falls into the abdominal cavity. Develops peritonitis. Peritonitis is an acute inflammation of the peritoneum (visceral and parietal). This inflammation does not tend to be delimited. But if the inflammation is of a delineated nature, then they speak of an abscess. An abscess is also called an inflammatory infiltrate, which is also a possible complication in acute appendicitis. Mesenteriolitis is a complication of acute appendicitis, which is an inflammation of the mesentery of the appendix. Intestinal need for acute appendicitis occurs infrequently. This complication occurs when the intestinal muscles stop working. They can stop functioning as a result of inflammation around the appendix.
Sepsis is a dangerous complication of acute appendicitis.
Sepsis is a blood poisoning. This condition develops as a result of getting into the blood of bacteria. These bacteria with the eye of the blood are transferred to other organs and tissues. True, this complication is rare.
The term appendicitis has been used since the nineteenth century.
It was first used in 1886. At the same time it was discovered that the most effective way to treat this disease is to remove the appendix (vermiform appendage). The very operation to remove the appendix – the first in history – was carried out in 1888. The first operations took place in Germany and England. In 1889, the clinical picture of appendicitis was compiled. It was described by McBurney. Currently, one of the symptoms of the disease bears the name of this scientist, as well as the oblique incision itself, which surgeons perform to get to the vermiform appendage. But in practice this section was applied not by McBurney, but by MacArthur. In the same year 1888, a similar operation was carried out in Russia. Did her doctor Dombrovsky in the Petropavlovsk hospital. A little later the removal of the appendix was carried out by the doctor of the Obukhov hospital – Troyanov. In 1909 – immediately after the Congress of Russian Surgeons – the operation to remove the appendix was started more widely.
in the second half of the twentieth century (in 1961) surgeon Rozanov had an operation of appendectomy. This event is noteworthy because the surgeon performed it on himself. In the conditions of work in Antarctica there was no other possibility, of course.
Eating healthy food is the main way to prevent acute appendicitis.
In general, eating healthy foods reduces the risk of all diseases.In order to avoid the possible development of appendicitis, it is worthwhile to reduce the amount of meat consumed, since it is known that people who eat only plant foods are less likely to develop acute appendicitis. Foods rich in fiber contribute to protecting the body from the appearance of appendicitis. Severe complications of acute appendicitis can not be tolerated by people with chronic appendicitis through surgery – then the risk of developing acute appendicitis and its complications will be reduced to zero.