Appendicitis. Causes, symptoms, diagnosis and treatment. Diagnostics at home and self-diagnosis. Appendicitis can also be chronic

Many people are interested in whether appendicitis can last for a week or more. If we're talking about about acute appendicitis, then without surgical intervention during this period a person may lose his life. It’s a completely different matter when the disease becomes chronic. In this case, the symptoms can torment the person for a very long time. But this happens quite rarely.

Appendicitis is inflammation of the appendix ( vermiform appendix, appendage of the cecum). According to statistics, this pathology is the most frequent illness which requires surgical intervention. It is observed in both elderly people and children (except infants).

1 Causes and symptoms of pathology

Controversy over etiology of this disease continue to this day. Scientists still cannot come to a consensus on what exactly causes inflammation of the cecal appendage. However, it has been proven that appendicitis can occur under the influence of the following factors:

infectious diseases of various localizations;
excretion disorder feces and blockage of the mouth of the epididymis with fecal stone;
excessive consumption of meat, fried, fatty, smoked foods;
individual abnormalities in the structure of the appendix (great length, bends);
arterial blockage;
atherosclerosis;
heart disease;
heart rhythm disturbance;
hereditary predisposition to diseases of this type;
alcohol abuse;
decline protective functions body;
smoking;
inflammatory diseases gynecological field(among women).

Usually the same in all cases, with rare exceptions. First of all, the patient begins to feel pain in upper area abdomen, which then pass into the right bottom part. The pain is dull and moderate in nature and intensifies when changing body position, laughing, coughing. The stomach may hurt for several days, but as the disease progresses this symptom may calm down. This indicates the death of the appendix and the development of peritonitis - inflammation of the abdominal region.

Along with the pain, the following symptoms appear:

periodic nausea and vomiting;
loss of appetite;
feeling of dry mouth, constant thirst;
loose stools;
increased body temperature;
decrease or increase in blood pressure;
increased heart rate.

If appendicitis is chronic, the symptoms may be less pronounced. However, they appear periodically.

2 Diagnosis and treatment of appendicitis

When diagnosing a disease, the first step is to general examination patient and abdominal palpation. When pressing on the abdomen, the patient usually feels pain in the right iliac region. The pain becomes throbbing when pinched sigmoid colon. You may also need general analysis blood. Indicates the development of appendicitis increased number leukocytes. If there are difficulties in diagnosing, the laparoscopy method is used.

Inflammation of the appendix can be confused with diseases such as cholecystitis, pancreatitis, peptic ulcer, and diseases of the female genital area.

Today, there is only one method of treating appendicitis - surgical removal of the appendix of the cecum. In this case, a laparoscopic appendectomy is usually performed. This method allows you to avoid excessive trauma and blood loss. In this case, the rehabilitation period is minimized and there are no large scars in the area of the operation.

If left untreated, the following complications may occur:

development of an abscess in abdominal cavity;
peritonitis;
appendicular infiltrate (fusion of modified tissues with each other);
pylephlebitis (inflammation portal vein liver as a result of infection).

To prevent appendicitis, any disease should be treated in a timely manner. digestive tract, stick to proper nutrition and give up bad habits.

It should be remembered that no other methods are effective, so trying to cure appendicitis at home is absolutely impossible. At the first symptoms, it is recommended to run to the doctor as fast as you can, because if left untreated, the disease can develop into peritonitis in one day, which, in turn, can lead to death.

To the question whether appendicitis can hurt for a week, there are two answers: maybe, if the appendix cannot be operated on and after a second attack the disease can become chronic. The second answer is also positive: yes, but during this time the patient can lose not only his health, but also his life.

Many experts believe that the appendix is a surplus in the body that requires removal regardless of the situation.

What is appendicitis

The very name of the disease means inflammatory process in acute form. Often inflammation of the appendix appears on the very dangerous stage- purulent appendicitis. The appendix is an organ in the form of a process, which during evolutionary changes has lost its relevance. Inflammatory processes occur for various reasons.

Due to impaired blood circulation in the organ.
Accumulation of roundworms.
Abdominal injury.
Stool deposition and concentration.

The inflammatory process has different characteristics: light form diseases and manifestations of necrotic processes of gangrenous type. In the second case, the stomach may hurt for three to four days, during which time the abdominal and intestinal tissues around the appendix begin to die. There are frequent cases when catarrhal appendicitis (a mild form of the disease), within a short period of time (several hours), turns into gangrene, which prevents several days from being used to prepare for surgery.

In this case, the time allotted for the operation is calculated in hours.

The abdomen may hurt for several days and then tissue death can lead to inflammation of the abdominal cavity, or peritonitis, which is dangerous blood poisoning. At this stage of the disease it is quite possible death. The life and death of a patient depends on how many hours or minutes of precious time surgeons have. Another complication that can occur during a week of inflammation of appendicitis is pylephlebitis. With pylephlebitis, irreversible processes associated with liver functions occur.

Duration and nature of the disease

There are times when chronic appendicitis may bother the patient for several months, and patients living with this diagnosis may feel constant pain in a stomach. The inflammatory process may appear for several days, and then go away and not bother you long time, or constantly create discomfort and remind yourself.

Sometimes appendix surgically it is impossible to remove due to the formation of an appendicular infiltrate (a case when the density of the lump contains connections with other organs). If a repeated attack of appendicitis occurs under such circumstances, the disease becomes chronic and at this stage can persist for a long time, sometimes for several months. During this period, the patient may experience constant aching pain, as well as impulsive attacks that bother you from time to time.

At the stage of chronic appendicitis, other manifestations of the disease are possible. An attack can pass quickly - literally in one day, and this is explained by the peculiarity of the foci of inflammation. In response to the question whether appendicitis can hurt for a long time, experts say that only at the stage chronic form this disease can persist for a long period.

Is it possible to do without surgery?

As studies have shown, removal of the appendix sometimes makes itself felt in completely unexpected manifestations. Removal of this organ in children early age often leads to mental retardation, and in people who undergo surgery in adulthood, the risk of developing bowel cancer increases. You should not immediately panic if you have abdominal pain in the appendix area and have all the symptoms of this disease: fever and vomiting.

In some cases, the attack resolves quite quickly and independently. Cases where a breakthrough occurs directly into the colon, without entering the abdominal cavity, are not uncommon. The site of the breakthrough hurts for a day or several (two or three), diarrhea is observed, the body completely recovers normal work all organs from a week to two. This situation occurs in older people, and there are often cases when they do not even suspect what exactly happened. If pain in the stomach continues for more than one day, the situation needs to be taken under control to avoid peritonitis. If the diagnosis is confirmed by a specialist, a reasonable decision would be surgery. By the end of the week general state returns to normal, and the patient can resume his previous lifestyle.

Diagnosis rules

The peculiarity of appendicitis is the suddenness of the onset of symptoms and the transience of the inflammatory process.

The first signal is pain in the area of the right hypochondrium, closer to the navel, or the epigastric region.
Along with increased pain, new symptoms arise: nausea, dizziness, nausea, vomiting, lack of appetite.
After some time, chills and fever appear, accompanied by high temperature. The pain develops and moves closer to the right side, with increasing nausea and weakness.

The listed symptoms are classic for inflammation of the appendix and require quick clarification by specialists.

Difficult to diagnose early period development of appendicitis: during the first 3 hours the patient cannot accurately determine the location of the pain; it is wandering in nature. The confusion is enhanced by the inability to fix the body in a certain position, the pain is constantly moving, its attacks can both intensify and weaken.

After 3 hours from the onset of the attack, the doctor can accurately diagnose the disease: the pain becomes constant and in one place, the patient is sick due to severe attacks practically cannot move independently.

Unusual manifestations in the form of incorrect location of the appendix, when its location is in the posterior part of the cecum, are not so uncommon (6-20%) of people. This case in medicine is called appendicitis of the retrocecal type; pain can manifest itself as right side lumbar region, and closer to the stomach.

Diagnostics using ultrasound does not provide a guarantee for establishing a diagnosis, only X-ray gives full picture the presence of an inflammatory process.

Self-diagnosis of an attack

You can diagnose the disease yourself; this requires the following steps:

Take the fetal position, while lying on your right side.
While straightening your legs, smoothly roll over onto your left side. If there is a sharp increase in pain during a turn, left side inflammation of the appendix is diagnosed. Attenuation pain means the problem is somewhere else.
Severe pain with appendicitis makes it impossible to strain the abdominal muscles; if the patient tries to cough, this will cause acute attack and an increase in pain.
If you lightly press the place where the pain is felt with your palm and then quickly release it, increasing pain during recovery indicates the presence of inflammation of the appendix.

In any case, if signs of illness appear, it is best to call an ambulance or invite specialists to make a diagnosis. Some of the symptoms are characteristic not only of an attack of appendicitis, therefore comprehensive examination necessary to accurately determine the cause of pain and other symptoms.

Appendicitis

I am 29 years old, four years ago for a long time I had long-term pain in the side. I went to the doctor and he explained to me that it was chronic appendicitis (cases of which occurred in childhood). After that, with similar symptoms, I applied ice to my side and everything went away. But now, for about five months, pain in the side began to appear periodically after two to three weeks and last up to two weeks or more. Please tell me if this could be appendicitis and I shouldn't worry or is it something else and should I see a doctor?

Sometimes, against the background of inflammatory processes in the intestines that were previously present, such residual pain can form (when the problem has disappeared, and nervous system still falsely “remembers” her). To be sure of this, undergo a dispensary (preventive) examination with a consultation with a gynecologist, urologist, neurologist, or gastroenterologist. If everything is in order, this will give you confidence and not to worry, but to adapt to your situation - maybe you will notice that pain occurs more often if you eat sweet or spicy (other foods), maybe at this time you need to go on a diet - fermented milk or..., don’t drink coffee,..., or maybe decoctions will help you at this time medicinal herbs(gastrointestinal fees), etc.

What does chronic appendicitis mean? why can't it be removed? what to do when you have an attack?

Chronic appendicitis is a chronic recurrent inflammation of the appendix - the vermiform appendix of the rectum. For frequent attacks it is indicated surgery. In case of each attack, it is necessary to contact a surgeon or call Ambulance, since there is a danger of developing peritonitis - inflammation of the peritoneum due to rupture of the appendix. Heating pads and compresses on the stomach are contraindicated. Self-administration of painkillers, including baralgin, is dangerous, since these drugs mask the manifestations of the disease and can interfere with the timely diagnosis of peritonitis.

what is the most reliable way to diagnose chronic appendicitis and whether it should be cut out

Chronic appendicitis is a controversial concept. Modern view: it refers to a very rare disorder of the immune system of the intestines (including the appendix), which can lead to periodic pain. This condition differs from ordinary appendicitis, which is fraught with severe inflammation, rupture of the appendix and peritonitis; with chronic appendicitis, the likelihood of complications developing is low. In addition, there are many other diseases that occur with a similar clinical picture: Crohn's disease, diverticulitis, chronic colitis, pancreatitis, typhlitis, etc., dysbacteriosis. Sometimes the changes are so subtle that a correct diagnosis can only be made by cutting off the process and looking at it under a microscope. Therefore, the diagnosis is made by excluding the above conditions. There is no point in chasing this diagnosis, it is quite rare, and the reason for your complaints may turn out to be simpler. Chronic appendicitis itself does not require surgery (i.e., preservation of the appendix is not life-threatening). But if it (really he) causes constant pain and disrupts the quality of life, if you constantly think and worry about it, then you can resort to surgery - not for treatment, but to eliminate pain and anxiety.

nutrition after appendectomy

If the operation was completed without complications (peritonitis), then after discharge from the hospital no special dietary restrictions are required.

The mortality rate due to it seems to be low: only 0.2-0.3%, but behind such insignificant figures lies about 3000 human lives that doctors cannot save. And in summer period, when many people are at their dachas and far from doctors, it is especially important to be able to distinguish appendicitis from normal pain in the stomach in order to consult a doctor in time.

Blind but dangerous

The appendix is a short and thin blind vermiform appendix 7-10 cm long, located at the end of the cecum (the initial part of the large intestine). Like any part of the intestine, the appendix produces intestinal juice, but so little that it does not play a special role in digestion. Therefore it for a long time was considered a “mistake of nature” and was removed by the patient at the first opportunity. But recently, scientists discovered lymphoid cells in the caecum, the same as in human tonsils. And since these cells have the properties to protect the body from infections, the assumption was born that the appendix is part of the immune system.

However, the number of protective cells in it, as it turned out, is very insignificant and strong influence cannot have an effect on immunity. So most experts are still confident that there is no benefit from the appendix, but the harm in case of its inflammation can be significant: not diagnosed in time acute appendicitis can cost not only health, but also life.

Are your teeth to blame?

Experts do not agree on the exact causes of appendicitis. However, risk groups have been identified.

For example, people suffering from diseases such as chronic sore throat, pneumonia, persistent colds, diseases gastrointestinal tract, caries. As a result of these diseases, infections penetrate through the bloodstream into the appendix and provoke an inflammatory process there. So healthy teeth- guarantee of health for appendicitis.

There is also a stress theory. It is based on the fact that as a result of excitement a person experiences sharp narrowing blood vessels and this leads to sudden bleeding of the appendix and the development of its inflammation.

But most often the occurrence of appendicitis is explained by blockage of the junction of the colon and the appendix, which often happens with constipation and chronic colitis.

How to identify him?

In most people, the appendix is located approximately halfway between the navel and the right ilium. In this place, with appendicitis, the maximum pain is felt. But if the appendix is raised to the right hypochondrium, closer to the liver, pain will appear in this area. And if the appendix is lowered into the lower part of the pelvis, then in women appendicitis is easily confused with inflammation of the appendages, in men - Bladder.

When the process is located behind the cecum, when it is wrapped towards the kidney and ureter, pain occurs in the lower back, radiating to the groin, leg, and pelvic area. If the process is directed inside the abdomen, then pain appears closer to the navel, in the middle abdomen and even in the pit of the stomach.

Pain occurs suddenly, without any obvious reason . At first they are not too strong - they can still be tolerated. And sometimes, from the first minutes of an attack of acute appendicitis, they become unbearable and proceed like colic.

Pain will torment a person as long as he lives nerve endings process. When will his death occur? nerve cells will die and the pain will subside. But this is no reason to calm down. Appendicitis will not resolve. On the contrary, the retreat of pain is a reason for immediate hospitalization. Acute appendicitis is accompanied by other symptoms. At the onset of the disease, general malaise, weakness, and loss of appetite appear. Nausea and sometimes vomiting may soon occur, but only once. A typical temperature ranges from 37.2 to 37.7 degrees, sometimes accompanied by chills. A white or yellowish coating appears on the tongue.

Help to recognize appendicitis simple techniques. But keep in mind that self-diagnosis must be carried out very carefully.

1 . Lightly tap with the pad of your bent index finger in the area of the right ilium - with appendicitis it always hurts there.

2 . For comparison, also tap on the left iliac region, which in case of inflammation of the appendix will not cause pain. Attention: you cannot carry out palpation (feeling the abdomen with your hands) yourself, there is a danger of rupturing the appendix, which usually leads to peritonitis.

3. Try coughing loudly: increased pain in the right iliac region will tell you that you have appendicitis.

4 . Apply gentle pressure with your palm to the area of your abdomen where it hurts the most. Hold your hand here for 5-10 seconds. The pain will ease slightly. Now remove your hand. If pain appears at this moment, this is a sign of acute appendicitis.

5 . Take a fetal position, that is, lie on your right side and pull your legs towards your body. With appendicitis, abdominal pain will ease. If you turn on your left side and straighten your legs, it will intensify. This is also a sign of acute appendicitis.

But self-diagnosis should be limited to this. Do not hesitate to consult a doctor, since appendicitis itself and all the diseases that it can masquerade as ( renal colic, exacerbation of pancreatitis or cholecystitis, peptic ulcers stomach and duodenum, acute inflammation bladder, kidneys, female organs), require hospitalization!

How to treat

If a diagnosis of acute appendicitis is made, the primary treatment is one - emergency surgery. Currently there is a gentle laparoscopic method, in which the appendix can be removed without a large incision. Unfortunately, in our country this type of operation is not yet widespread enough due to the poor technical equipment of hospitals.

the main task postoperative period- avoid complications, for example, suppuration of a postoperative wound. In their occurrence, most often there is no fault of the surgeon. Whether or not this complication occurs depends on the state of the appendix at the time of surgery - the greater the degree of inflammation, the higher the risk of suppuration.

If the operation was successful, young patients have their stitches removed already on the 6-7th day and discharged from the hospital. But for older people, as well as with chronic diseases (diabetes mellitus, hypertension, cardiac ischemia, etc.) the sutures are removed 2-3 days later. After this, it is advisable to seal the wound with an adhesive plaster.

Do not take a bath or go to the sauna for about a month: water and temperature loads on fragile scar tissue make the seam rougher, wider and unsightly. At least three months, and older people should not lift weights for six months. Avoid sports that strain your abdominal muscles. Try not to catch a cold: coughing is dangerous for you.

Hard case

If you try to “endure” appendicitis, peritonitis may occur - inflammation of the abdominal cavity. Its symptoms:

increasing pain throughout the abdomen, nausea, vomiting, severe cases- drowsiness, lethargy, bluish tint to the face;

pulse up to 120-140 beats per minute, temperature up to 39-40 C;

the tongue is covered with a white coating, then becomes dry, like a crust, the lips dry out and crack;

the stomach is swollen, it hurts in all its areas, but especially on the right.

Peritonitis can only be treated surgically. Moreover, the operation is very complex and lengthy. Unfortunately, it is not always possible to save the patient. That is why, if you experience any abdominal pain, you should never delay visiting a doctor. As they say, we don’t want to scare anyone, but everyone should remember how dangerous appendicitis is.