Appendicitis is a pathological condition of a patient with inflammation of the cecum process. Pathology develops rapidly, carries a threat to life, aggravated by a strong attack of pain. Late receipt of the help of specialists leads to the development of complications, even the death of the patient. With symptoms of inflammation of the appendix in adults and children, you need to call the ambulance team, know how to help yourself and your neighbor in case of indisposition. What to do if you suspect appendicitis, how to understand what happened attack, how to behave to prevent complications before the arrival of an ambulance - discussed in the article.
With this type of disease, there are several stages. One stage in time passes into another, if there was no intervention from the side of doctors. They say about:
- Catarrhal stage. Inflammation of appendicitis at this step usually affects only the mucous membrane of the appendix.
- Surface form. In this case, progress is relatively catarrhal, which leads to damage to the mucous membrane of the organ. By studying the lumen of the appendix, one can see leukocytes and blood.
- Phlegmonous stage. It is characterized by inflammation that affects all layers of the tissues of the organ. Destructive processes affected, including the outer shell of the appendix.
- Phlegmonous and ulcerative. This form is characterized by ulceration of the surface of the mucous, protecting the organ from the outside.
- Gangrenous. This stage is characterized by the death of the wall of the process. Often there is a breakthrough of tissues, causing the contents of the appendix to pour into the abdominal cavity, which provokes peritonitis. With the development of appendicitis to this stage, the probability of death is high.
Time does not tolerate
As a rule, inflammation of the appendix goes through all the steps described earlier in just 48 hours. Acute inflammation of appendicitis is a dangerous disease that does not tolerate delay.
At the first sign of an urgent need to visit the surgeon. If the disease has reached the phlegmonous stage, the risk of complications increases.
Pain as the first signal
Highlighting signs of appendicitis inflammation, pain is primarily mentioned. It appears in the area near the navel. Feels like stupid, not passing over time, constant. Sometimes the stomach hurts from above, approximately to the middle. Less commonly, painful sensations cover the abdomen completely. Sometimes pain is felt right in the iliac region.
Increased discomfort occurs when a person walks, bends over. Pursue sharp discomfort when coughing and laughing. It is very painful to sneeze. But older people tend to the absence of pain.
Please note that with an atypical location of the appendix pain syndrome can be felt in an unpredictable place. Sometimes it hurts on the right under the ribs, near the pubis, or in the area of the kidneys, ureters. Pain may be given to the hips or lower back. In some cases, it is noted that the pain is felt in the external genitals. An unspecified area on the left side of the body may hurt.
A few hours after the initial onset of pain, the sensations shift towards the appendix. These signs of inflammation of appendicitis in women are very important: if you suddenly stop feeling pain, there is a high probability that the disease will turn into a gangrenous form, which is associated with the death of nerve endings in the affected area. You can not pull: you need to urgently call a doctor!
Nausea and vomiting is appendicitis
Particular signs of inflammation of appendicitis in adult men and women are vomiting and nausea, which accompany pain syndrome. Please note: before the onset of pain such sensations are not observed. If nausea first appeared, and only then pain came, there is a chance that it is not a problem of an inflamed appendix, but another pathology, which the doctor will be able to diagnose.
You should also be aware that in most cases vomiting occurs only once. Why is this characteristic inflammation of appendicitis? Symptoms in adults suggest that it is a reflex toxin rejection by the body.
Language and temperature
The characteristic symptoms of inflammation of appendicitis in women and men include changes in the tongue. At the beginning of the disease, it is usually wet and covered with a thin white bloom. With the progression of appendicitis, the tongue becomes dry. This shows that peritoneal inflammation has begun.
The temperature usually rises insignificantly. How to determine the inflammation of appendicitis, focusing on it? Remember that patients usually have a temperature of 37 to 38 degrees. It remains for a long time without changes. In rare cases, the rise is fixed above 38 degrees. But if the body temperature has risen even higher, it is safe to say that the inflammatory process is progressing in earnest.
What else to pay attention to?
The characteristic signs of appendicitis inflammation, which make it possible to suspect the disease, include stool, although this is more typical for the elderly. Mark constipation. If the appendix is located near the loops of the small intestine, the likelihood of diarrhea is high. For this reason, there are frequent cases of erroneous hospitalization of the patient in the infectious disease wards.
Due to the severe state of the body, sleep is disturbed. General discomfort strongly influences a person’s feeling of his body, pursues a state of fatigue, lethargy, and indifference.
The appetite for acute appendicitis usually disappears completely.
Statistics show that this form develops very rarely, not more often than in one percent of all cases of inflammation of the appendix. Inflammation after appendicitis is manifested by pain in the right iliac region. Feels dull. Localization of pain is valid for a typically located organ.
How to determine the inflammation of appendicitis, if the disease has passed into the chronic form? Only one option: visit a doctor who will conduct a full range of diagnostics. Typically, research includes:
Easy to confuse
Chronic appendicitis in its manifestations is close to a variety of diseases, including:
- chronic cholecystitis.
Chronic inflammation of appendicitis can be suspected if soreness regularly increases, when the person moves the body (bends, turns). When the disease becomes aggravated, the temperature rises slightly, the general manifestations are similar to the acute form.
What is dangerous?
Chronic appendicitis is dangerous in the first place because it can cause peritonitis. If you suspect a disease, you should urgently visit a doctor to assess exactly how severe the patient's condition is.
In general, practice shows that it is the timely access to a doctor that saves people’s life. Having podzatyanu with calling an ambulance, you can, at best, “reward” yourself with very unpleasant moments of sharp pain, at worst a lethal outcome.
That also happens!
One of the most famous cases of appendicitis treatment in modern medicine occurred at the Soviet station in Antarctica, where doctor Leonid Rogozov was among the permanent staff. During his stay at the station for obvious symptoms, the specialist diagnosed himself with acute inflammation of appendicitis.
At first there were attempts to apply conservative methods of treatment: they resorted to ice, antibiotics and starvation. But this practice did not show results. There were no other doctors at the station at that moment. The doctor decided to independently carry out the operation on himself and immediately began to do so.
During the operation, a mechanical engineer at the research station held a mirror, a meteorologist was involved - he served the instruments. The doctor operated on himself for almost two hours. The result was successful. Just a week later, the doctor was able to perform his regular functions again. An example of this operation is one of the most famous in our world, demonstrating human courage and readiness to fight with any difficulties.
And if in ordinary life?
Of course, the stories about the incidents at the Arctic stations are curious to everyone, but in everyday life, in everyday life, everything is much simpler. With signs of appendicitis, there is no need to show miracles of courage and become a hero, you just need to take advantage of medical care in a timely manner. Who to contact if there is suspicion of appendicitis?
First of all, call an ambulance. As a rule, by the time a person realizes that he needs the help of a doctor, it is too late to go to the clinic himself - the pain accompanying every movement, and even a slight cough, is too strong. Turning to the services of ambulance, the patient quickly, already in his bed at home, receives a primary diagnosis.
The next stage is the examination of the patient by a therapist in a hospital setting. Here, under the control of the anesthesiologist, an accurate diagnosis will be made and it will be determined what the stage of the disease is and what measures need to be taken. In some cases, the inflammation of the appendix is accompanied by severe pathologies that develop against the background of the disease of the vermiform process. Then you have to bring to the treatment of specialized doctors. The most complicated cases of inflammation of the appendix, accompanied by:
- recent heart attack,
- decompensated diabetes.
Children - a special case
As a rule, diagnosis of appendix inflammation in young children is distinguished by increased complexity. The child can not explain clearly and clearly what it hurts him and where. In some cases, inflammation develops at such an early age that the baby still does not even know how to speak. How to suspect the disease in this case?
Usually, when an appendix develops, a small child cries a lot, worries, as if showing his stomach to others. But if adults try to touch, he shows a protest and only cries louder and shouts. The disease develops gradually, the symptoms build up over time.
During the day, the sick child squats and bursts into tears without any preconditions to that. At night, children often wake up from pain. The development of the disease manifests itself vomiting and nausea. If in adults it is a one-time phenomenon, then in young children it is repeated many times. Doctors say that this is a reflex reaction of the body to toxins, the release of which accompanies the inflammatory process.
Older people have their own characteristics
As for older people, they have an inflammation of appendicitis with a number of characteristic features that complicate the diagnosis of the disease. First of all, it is a weak pain syndrome, which is often absent altogether. Because of this, the determination of appendicitis occurs with a significant delay.
It is possible to suspect that something is wrong due to the lost appetite and tension characteristic of the muscles on the right, in the iliac region. You can feel it by palpation of a part of the body. However, it is not recommended to investigate the body by yourself, as you can harm yourself. Also in the elderly, various atypical appendicitis manifestations, which science has not yet been able to systematize, are observed. Therefore, it is recommended to visit a doctor for any doubtful signs, to be tested and a full range of studies. This will determine whether the appendix has inflamed, as well as identify associated pathologies.
Symptoms of appendicitis are diverse, and the main cunning of the disease is that its manifestations are often confused with a simple cold or other diseases. Sometimes appendicitis is similar to cholecystitis, in other cases it manifests itself as signs characteristic of inflammation of the appendages or even pregnancy with the attachment of a fruit egg outside the uterus.
It hurts, oh, how hurts!
The main symptom of appendicitis is pain, but this condition cannot be identified only by pain. In addition, the condition may manifest itself fever, nausea and vomiting, a violation of the chair. However, all these phenomena are not required. Among older patients, they are most often not noticed. Suspect appendicitis can be a sudden and sharp pain in the abdomen. With this symptom, you should immediately turn to the ambulance team, even if the pain is tolerable. By the way, a symptom may disappear after a while, but this is not a reason to calm down - such a phenomenon may indicate a change of form to a more severe one.
With symptoms of appendicitis, you should not try to relieve the condition with painkillers or antimicrobial drugs. Indeed, the pain may subside, but the picture of the disease, the clinical symptoms will be blurred, which will complicate the exact diagnosis. Suspecting appendicitis, it is necessary to abandon a hot bath or relieve pain with a heating pad, as this can intensify the inflammatory process and the spreading of purulent discharges throughout the abdominal cavity. It is dangerous to use choleretic drugs, put an enema. First aid to the patient at home - call the ambulance brigade and ensure complete rest.
Having noticed doubtful symptoms, it is necessary to call a doctor. The patient will be taken to the clinic, where they will check the main vital signs of the body and will identify laboratory signs of appendicitis if the problem is in it. The doctor feels the sore area, but this is unlikely to allow an accurate diagnosis. To check the condition, they will first take blood samples, urine, for examination, and then send it to an ultrasound test of the abdominal cavity. The presence of an inflammatory focus confirms an increased concentration of leukocytes.
In order to make sure that the symptoms are observed, signs of appendicitis, laparoscopy is prescribed. A small puncture is made in the abdominal wall, a device is inserted into the human body, which transmits an image in real time via a cable to the monitor. So the doctor can determine exactly what happens to a person, what causes pain.
Forms and stages
It is most difficult to identify the symptoms of appendicitis at home, when the disease is just beginning to develop. The first half day is the catarrhal form. In the area of the stomach there is pain, discomfort, but they are usually not strong enough to cause anxiety. Many people confuse them with gastritis. Feelings become stronger in the evening, at night. Soreness is dull, considered by many to be insignificant. Vomiting possible, nauseous. Doctors say that this phenomenon is associated with human reflexes. In elderly patients, vomiting is almost always absent or is very weak. This complicates timely and accurate diagnosis.
It is possible to suspect appendicitis symptoms at home if morbidity in the first half day from the moment of onset migrates into the stomach from the bottom right, if the appendix is located on the right (anatomical anomalies are possible, this should be taken into account). Gradually, the pain begins to throb and press, and the intensity increases. In some, the development of the state is accompanied by loose stools and frequent urge to urinate.
Symptoms of appendicitis in adults and children at an initial stage include a temperature rise above 37 degrees. Gradually, various signs of general poisoning appear, including weakness, frequent heartbeat, and dry mouth. The pain is getting worse, getting harder and harder. The abdomen is soft, palpation on the right responds with pain.This stage is better than the others for emergency surgery, but it is rarely possible to identify the pathology, and people are delaying with an appeal to a specialist.
How to determine the symptoms of appendicitis? In women, men, the disease that was left unattended at the catalisation stage described above manifests itself with increasing discomfort over time. By the end of the first day, the pain is already clearly defined in the right lower abdomen, intense and pulsating. The patient is constantly feeling nauseous. The heart rate is about 90 beats per minute. The temperature is close to 38 degrees. If you visually inspect the patient, it is clear that the right abdomen during inhalation and exhalation lags behind the left.
There is tension at the bottom right of this stage of appendicitis. This indicates the spread of the inflammatory focus on the peritoneum. The diagnostic symptoms of appendicitis in men, women at this stage are all positive, making it easy for the doctor to determine exactly what needs to be treated. As a rule, at this stage the patient is sent for emergency surgery.
Second and third day
The third stage of the disease is gangrenous. Symptoms of appendicitis in women, men change again. First, the pain subsides. This indicates the death of nerve cells localized near the inflammatory focus, due to which the sensitivity becomes less. But the general poisoning manifests itself brighter. Tachycardia is stronger, the patient vomits. The temperature drops first to normal, then to 36 degrees and even less.
Doctors know exactly how to determine the symptoms of appendicitis at this stage: there is no peristalsis, the abdomen is swollen, and touching the body in the area of the appendix brings severe pain to the patient.
Symptoms of appendicitis in women, men who have reached the case before the transition to the perforating phase, include a very strong pain. The pain is clearly defined on the right side of the lower abdomen, with time it gets stronger, there is no relief even for a short time, the pain is constant. The patient vomits many times, worries about a strong tachycardia. Even with a visual inspection can see how tense the stomach, noticeable swelling. No peristalsis. The tongue is covered with a brownish bloom, the body temperature rises to 40 degrees, sometimes even higher.
If you ignore the symptoms of appendicitis, in women, men, the phase of peritonitis or abscess begins.
Not everything goes according to plan.
Appendicitis can develop in the form described above - this is a typical disease scenario. There is a risk of atypical development when clinical symptoms are absent, although there are inflammatory processes in the body. There are several atypical forms, each of which has its own characteristics.
Quite rarely, symptoms of appendicitis are observed in women, men, developing according to the type of empyema. This term refers to a condition where pain is immediately localized to the right in the lower abdomen, deterioration occurs gradually, pain is relatively weak. Poisoning of the body shows itself only by the fifth day of the development of pathology, the patient has shivering, fever appears, and the condition is weak.
Sometimes the symptoms of appendicitis in women, men indicate a retrocecal form. On average, it is detected in every tenth patient. The primary symptoms of the disease are mild, the temperature rises to fairly high rates, the stool is semi-fluid, and mucous discharge is possible. In some cases, the pain is localized in the lower back and gives to the thigh on the right side.
Symptoms of appendicitis developing in the pelvic scenario are possible in women. On average, it accounts for about 9-18% of all patients. The disease manifests itself with a liquid stool containing mucous discharge. There is irritation of the peritoneum, but rather weak. A slight rise in temperature is possible, but the general poisoning of the body is practically not felt.
Possible options: what else happens?
Subhepatic appendicitis is possible. With this form of the disease, the discomfort is localized under the ribs on the right.
In pregnancy, appendicitis often appears in the second half of the term. The condition is expressed by moderate signs of strength, pain - closer to the right side of the body under the ribs. Evaluation of the condition of the expectant mother begins with a temperature check. Heat is one of the first symptoms of appendicitis in women. How to determine the house in a particular case, the reason for the inflammation of the appendix, or not, no one will say - you can only clarify the condition in the clinic. Possible mild symptoms inherent in peritoneal irritation.
Sometimes signs, symptoms of appendicitis in women, men indicate a left-sided form. The picture is generally standard, but the pain is felt on the left. This is possible if a person has a specific anatomy from birth - the organs are arranged in reverse order. Left-sided appendicitis may develop with increased activity of the cecum.
The cases described above are acute appendicitis. In addition, the disease can develop as chronic. Symptoms of appendicitis in this case will include intermittent tenderness, which becomes stronger if you cough, walk, run. Relapse is possible in which the manifestations are similar to the acute form. At the chronicle, the temperature is normal or slightly above standard indicators (about 37 degrees).
On average, chronic appendicitis is diagnosed in one patient out of a hundred. Clinical manifestations may be similar to pyelonephritis, an ulcer or cholecystitis. Sometimes appendicitis manifests itself as a phenomenon peculiar to gynecological or other pathologies of organs localized in the abdominal cavity.
Special case: men get sick
Some manifestations of appendicitis, characteristic of men, are characteristic of women, but there are some distinctive features, peculiar only to the representatives of the stronger sex. As a rule, appendicitis can be suspected due to white bloom covering the tongue, pain and repeated vomiting, and an increase in temperature. The patient feels weak, he dries in his mouth, the rhythm of the contraction of the cardiac muscle sticks and becomes more frequent. When appendicitis appetite disappears, the chair is broken, the person is constantly in a forced position in which the pain is somewhat lighter.
Vomiting, nausea come after an attack of pain. First appetite weakens, gradually disappears altogether. The language of the first time of the disease is wet, gradually dries, whitens. If the focus of inflammation is located near the intestinal loops, diarrhea worries. When localized in the bladder, urge to urinate becomes more frequent.
Symptoms vary, much depends on the age, stage of the disease, the presence of background diseases.
When appendicitis soreness is often felt in the ileal region, but it is typical of people who have an inflamed organ is located as standard. When the pelvic position hurts near the pubis, when located behind the rectum - in the lower back or side of the abdomen. Can hurt right under the ribs, if the appendix is higher than the standard position. About seven hours from the moment the first soreness appears is enough time to understand exactly where the pain is felt. Especially strong sensations with careless movements. Sometimes they are provoked by coughing, laughing, talking. Relief comes when you curl into a fetal position.
A rather characteristic symptom of appendicitis in men is a pulling up of the testicle on the right. When the scrotum is pulled away, this area responds with pain. Pulling up occurs spontaneously, not controlled. With a slight swelling, the area hurts. Possible anal soreness, frequent urge to defecate. The pain can get worse if you try to raise an arm or leg to the right.
Children are ill: features
An acute form of the disease can occur at any age. From medical statistics it is known that more often sick children from 5 to 14 years. On average, among girls, the frequency of the pathology of a widow is higher than among boys. Symptoms may differ from those described above due to the structural features of the organ, insufficiently formed lymphoid tissue.
The basic symptom is abdominal pain, and it is possible in different areas - it depends on the peculiarities of the position of the affected organ. The baby is worried, does not eat, does not sleep, cries. There is fever, palpitations become more frequent, the stool becomes liquid, or constipation occurs. Abdominal distention is possible, sometimes - problems with urination, up to dysuria. Usually the disease appears suddenly, the symptoms progress rapidly.
Some time ago, scientists conducted statistical studies, the results of which turned out to be quite obvious: about 40% of patients with appendicitis came to the clinic after eating seeds and chips the day before. Especially pronounced dependence was among children of 14 years of age and close to it.
Atypical and typical options
Occasionally, in children with appendicitis, pain is felt in the groin, reproductive organs, stomach, or ureter. This greatly complicates the exact definition of the causes of pain. Often when children with appendicitis, they reflexively lie on their left side and tighten their legs to their chest - with such a position, the pain decreases. The child does not touch the stomach, cries and screams, cannot eat or sleep. As the baby calms down, it takes a certain position and does not move.
The patient's face turns red, white bloom is visible on the tongue, there is a fever and tachycardia. In middle-aged children, the pulse and temperature do not correspond to each other, in medicine this is called the scissors symptom. The patient vomits, but does not come at the same time.
Appendicitis (appendicitis) is an inflammatory process of the small vermiform process of the cecum, called appendix. The word “appendix” in translation from Latin means “appendage”, and the ending “itis” indicates inflammation.
According to statistics, among all surgical diseases, appendicitis takes about 89% of cases in terms of frequency of spread and is in the first place. Most often it occurs in people of young working age from 18 to 35 years. The prevalence of this disease in women is 2 times higher than in men.
Appendicitis can proceed in an acute and chronic form. The acute form is divided into the catarrhal course of the disease and destructive, which, in turn, can have several forms:
- phlegmonous and ulcerative,
Chronic appendicitis is also divided into several forms. He might be:
- primary chronic
All these forms of chronic appendicitis are distinguished by sclerotic and atrophic processes occurring in the appendix. The growth of granulation tissue in the walls of the appendix and its lumen, the formation of adhesions between the surrounding serous membranes can occur. In case of accumulation of serous fluid in the lumen of the vermiform process, a cyst is formed.
Appendicitis in children and adults: causes, symptoms and treatment
Very often, the patient does not pay attention to the pain in the abdomen immediately, but after a few hours or even days. This is due to the fact that the first signs of appendicitis in adults develop gradually and are uncertain. Difficulties arise in determining the specific area of pain. When taking pain medication pain can subside altogether and be felt only with sudden movements and a deep breath or cough.
Appendicitis: signs in adults
- Constant pain, which in the first hours is localized in the navel, then goes down to the right.
- Nausea and vomiting.
- Increase in body temperature to subfebrile.
If these symptoms (signs) of appendicitis in adults show up, then you should not hope that everything will resolve itself. We need to call an ambulance. An experienced team of doctors can easily identify such a dangerous disease that requires immediate hospitalization, as appendicitis. Signs in adults, as already mentioned, may be blurred. To clarify the diagnosis before the arrival of doctors you can conduct a self-diagnosis.
This is done as follows: in the lower abdomen to the right, you need to press firmly with two fingers (middle and index), while the pain should not be felt. Then the fingers are removed, and the pain increases sharply. If such a test was positive, i.e. everything turns out as described, besides nausea can be present, and in some cases vomiting, then, most likely, these are the first signs of appendicitis in adults. Now we will describe them in more detail.
With the diagnosis of appendicitis, the symptoms in adults may be somewhat blurred, but they all boil down to the following:
- First, there is pain in the abdomen, which is not clearly localized. It can manifest itself in the navel, epigastrium, or have a diffuse character (all over the abdomen). The pain is constant, sometimes it can be cramping. After an hour or more, it concentrates in the lower abdomen to the right. This symptom of moving pain is called Kocher-Volchkov. Irradiation of pain is usually not observed. This is only possible with an atypical location of the appendix. In this case, the pain may go to the groin or lumbar region.
- Patients, as a rule, have no appetite. This symptom is called anorexia.
- Following the pain develops nausea, and there may be a single vomiting. These signs of appendicitis in adults are reflex in nature and develop as a result of peritoneal irritation.
- Subfebrile temperature may rise, but this is not always the case. Signs of acute appendicitis in adults, such as fever, vomiting, and anorexia, are called Murphy's symptom.
With the appearance of such signs in a patient, acute appendicitis may be suspected. Sometimes these main symptoms of appendicitis in adults are accompanied by frequent urination, stool disorders (diarrhea), rapid pulse and, in rare cases, an increase in pressure. Other uncharacteristic symptoms of this disease can be observed in the elderly, children and pregnant women, as well as with the atypical location of the appendix of the cecum. What signs of appendicitis in adults are observed most often, we examined. Now let's talk about the features of the development of this disease in women, and also consider what danger it carries during pregnancy.
Features of the diagnosis of appendicitis in women
Representatives of the beautiful half of humanity are more likely to have an error in the diagnosis of this disease than men. This is due to the fact that sensations during the development of this disease can be confused with pain during menstruation or a painful reaction when an inflammatory process occurs in the gynecological region of the pelvic organs. This error may occur when the atypical location of the appendix.
To clarify the final diagnosis in a hospital, a woman other than a surgeon must also see a gynecologist. A distinctive symptom of inflammation of the appendix from the gynecological pathology is the fact that in the latter case vomiting, nausea and upset stool are not characteristic.
Symptoms of appendicitis in pregnant women
The signs of appendicitis in adult women are the same as in men. The exception is pregnant women. According to statistics, the incidence of appendicitis during pregnancy is about 5%. The representative of the beautiful half of humanity, preparing to become a mother, with this disease can be observed atypical form (in case of displacement of the appendix).
Diagnosis of appendicitis during pregnancy usually does not cause difficulties. Symptoms are the same as in other adults.Difficulties may occur in the last trimester of pregnancy, if the nature of the pain is cramping. Patients, as a rule, assume the forced position of the body lying on their backs with their knees bent and their legs pulled up to the belly. The pain is localized most often to the right in the iliac region, but in late pregnancy it can appear higher. Also in the last months of pregnancy, concerns are caused by surgical treatment of appendicitis and the postoperative period of rehabilitation. Therefore, it is extremely important to correctly diagnose.
Causes of appendicitis during pregnancy
This disease arises due to the fact that during the period of gestation of a baby, a greatly enlarged uterus can affect the cecum and change its position. Also, the appendix can be impaired by the enlarged uterus, as a result of which the blood supply is disturbed. This sometimes leads to an inflammatory and even gangrenous process. The cause of appendicitis in pregnant women also serves as a change in hormonal levels. During the carrying of a child, women often experience stool disorders, namely constipation, which can also trigger this pathology.
What is dangerous appendicitis during pregnancy?
Obviously, any surgical intervention, especially when it is performed in the abdomen of a pregnant woman, can cause miscarriage or premature birth. But besides this, it is dangerous in the following states:
- development of fetal hypoxia,
- placental abruption and premature fetal aging,
- the occurrence of acute intestinal obstruction,
- postoperative infection
- violation of uterine contractile activity during labor,
- the development of bleeding in the postpartum period.
Thus, we looked at all possible appendicitis symptoms and signs of disease in adults. Now let's pay attention to the features of the development of this disease in children.
Symptoms of appendicitis in older children
Symptoms in children of senior school age are similar to signs of this disease in adults. One can only add that such patients often occupy a forced position of the body, at which the intensity of pain decreases. They lie on your back or right side. In addition, the temperature rises to 38 degrees and even higher. Pulse does not correspond to the parameters of increase in body temperature and is highly speeded up.
On examination of the oral cavity, a wet tongue is noted, on which white bloom is present. A bad sign is dry tongue. This may indicate the development of gangrenous disease and peritonitis. In children of this age, there may be a delayed stool with this disease.
Symptoms of appendicitis in young children
In children, the signs of the disease being considered may be suspected in the following cases:
- The child is crying and does not allow to inspect.
- The baby pulls the right leg to the stomach and curls up.
- The temperature in small patients with a diagnosis of appendicitis often rises above 38 degrees, can reach up to 40.
- Pulse is frequent and corresponds to an elevated temperature.
- Stool liquid, frequent.
- Urination may be painful and rapid. When urinating baby cries.
- In young children, vomiting can be multiple.
- The child is restless, refuses to eat, cannot sleep, constantly asks to drink.
What signs of appendicitis in adults and children exist, we now know. Consider the possible dangerous consequences of this disease.
In some cases, the disease is complicated by the following processes:
- abscess of the abdominal cavity, which can be appendicular, subphrenic, interintestinal or Douglas depending on the site of localization,
- thrombophlebitis of the pelvic or iliac veins, this may be the cause of a very serious condition - pulmonary embolism,
- peritonitis, in case of rupture of the appendix,
- the formation of postoperative infiltration,
- the development of adhesions in the postoperative period, which can provoke intestinal obstruction.
If there are signs of inflammation of appendicitis in adults or children, then it is shown as soon as possible to make an appendectomy, i.e. removal of the appendix to avoid serious complications of this disease. This operation is carried out on an emergency basis - no later than an hour after the exact diagnosis.
At the stage of first aid, bed rest is recommended. It is strictly forbidden to take any food and drink. You can not take painkillers, laxatives and other drugs to clarify the final diagnosis, apply cold or heat.
After an accurate diagnosis of appendicitis is established (signs in adults and children are described above), the patient is placed in the surgical department and appendectomy is performed. With uncomplicated course, this operation is done with a laparoscopic method.
After that, the patient is transferred to resuscitation for several hours, where he is under constant medical supervision. After the patient finally withdraws from anesthesia, he is transferred to the surgical department. On the 5th day, the sutures are usually removed and the patient is transferred to outpatient treatment.
With a complicated course of this disease, the patient remains in the clinic, and his discharge will be delayed until the undesirable consequences are eliminated and the general condition stabilizes.
With an uncomplicated course of the disease and a timely, competently performed operation, appendicitis does not pose a threat to life. The patient’s full working capacity is restored after 4 weeks.
The reasons for the development of complications of appendicitis, as a rule, are untimely hospitalization and delayed surgery. In severe cases, it can even lead to death.
How to identify appendicitis at home
If you find yourself in a loved one of these symptoms, you need to make sure that there is an attack of appendicitis. For diagnosis at home it is necessary to feel the belly at the location of the appendix. When pressed, there is a firmness, tightness of the muscles of the peritoneum.
Methods for detecting appendicitis:
- The patient is instructed to lie on his back on a flat, hard surface.
- Press your fingers on the location of the appendix in the right side.
- Sharply remove the hand.
When, when feeling, pressing, there is a strong pain, the next step is to call an ambulance.
It is necessary to take into account a number of circumstances. Almost every patient with appendicitis feels nauseous, vomiting. Children feel the urge to nausea more often. Perhaps the appearance of constipation, diarrhea. Children endure the indicated symptoms at an elevated temperature almost always.
When it hurts badly, the patient wants to lie on his right side to ease the situation, curled up.
If a patient has colic in the abdomen, feels sick, vomiting is present, the abdomen is enlarged, swollen, the person cannot urinate - the situation is complicated, perhaps not just the presence of an attack of appendicitis, but a more serious illness, the development of a complication. Possible intestinal pathology, breakthrough appendix, the penetration of the contents into the body. You can not make unnecessary movements, the only option seems to be the call of the ambulance brigade or ambulance.
Options for helping yourself or your neighbor
While medical workers are on the way, it is important to provide all possible assistance to the patient with the attack. The main thing in a difficult situation - to remain calm, do no harm. It is important to know the rules of conduct for symptoms that indicate acute appendicitis. You will need to do the following:
- Providing rest, lying position.
- It is better for the patient not to get up, try not to move.
- You can not take the patient water, food, painkillers drugs. This will distort the picture, will give complications.
- It is important to put a cold object on the abdomen in the place of pain, a hot-water bottle with cold water, ice.
- In the presence of strong thirst allowed a glass of mineral water without gas.
- By the arrival of doctors to prepare the documents of the patient, necessary for admission to the hospital, policy, passport, money.
If you can get to the hospital as soon as possible, it is better to do it yourself. Appeal to doctors in the surgical department, other treatment options, in addition to surgery, with appendicitis are not assumed.
How to help a child
When an attack of appendicitis occurs in a child, the situation is complicated by the fact that children are not able to accurately determine the sensations, indicate the location of the pain, describe the symptoms. When a child is small, in infancy, a strong sign of inflammation of the appendix can be pulling, pressing your legs to yourself.
It is necessary to try to recognize the attack, feel the right side of the child’s abdomen. If there is a reaction in the form of a cry, appendicitis is probably inflamed. It is necessary to track the motor activity of the child. When appendicitis children refuse to get up, walk, often remain in the supine position.
Evidence of inflammation of the vermiform process in a child are the following signs:
- The kid loses his appetite, but is thirsty.
- Body temperature is elevated.
- The child does not move, lies on the right side, curled.
- When examining the tongue there is a bloom of gray.
- Perhaps the manifestation of diarrhea, constipation, urine becomes dark.
The only correct option to help the child will be to contact medical professionals. It is necessary to deliver the baby to the surgery independently, if there is no possibility - immediately call the ambulance team.
It is difficult to determine the state of appendicitis in a woman in a situation, sometimes symptoms are taken for manifestation of toxicosis. Symptoms of an attack in a woman during pregnancy do not appear immediately. Depending on the gestational age, the sensations may be located in different parts of the abdomen. At the beginning of pregnancy, up to 12 weeks, the pain is located in the navel, in the right side of the peritoneum. After the end of the first trimester, sensations appear more when lying on the side.
With the beginning of 4 months, the appendix is placed above, under the pressure of an enlarged uterus. Localization is determined closer to the liver of the woman. Sensations can be given to the area of the right kidney.
- Discomfort, feeling of pain when lying on the right side.
- Unpleasant sensations when feeling the left side of the ribs, in the prone position.
A woman, being in the state of carrying a child, especially after the end of the 1st trimester, is difficult to determine appendicitis on her own. The method of palpation is invalid, does not allow to establish an accurate diagnosis. It is important to seek medical help in time, to make a diagnosis with the help of equipment, by ultrasound.
In the absence of pregnancy, a woman must consult a gynecologist. It is important not to confuse the manifestation of an attack with inflammation of the appendages, gynecological ailments. Examination of the gynecologist is also indicated for the symptoms in girls.
Upon admission to the emergency department, the doctor necessarily interviews the patient, performs mandatory actions:
- Blood test, urine.
- Examination of the peritoneal cavity using ultrasound equipment.
- Examination using computed tomography.
These activities are required for accurate diagnosis, to exclude possible diseases with similar symptoms. It is important to distinguish appendicitis from other pathologies: intestinal colic, renal colic, inflammation of the digestive tract.
When confirming the appendix inflammation, the doctor prepares the patient for the operation, treatment of the attack is possible only surgically by removing the process of the cecum.
The patient needs to understand that the use of folk remedies and methods will not help in case of inflammation of the appendix, as well as the use of analgesics and other painkillers. It is important to seek help from a doctor in time: the course of the disease rapidly, with the wrong tactics, leads to serious complications and death.
Summarizing, it is worth highlighting the basic rules of behavior in the diagnosis of appendicitis in oneself or in one’s neighbor:
- Preparation of the necessary documents for admission to the hospital.
- Call an ambulance brigade or self-follow up to the department of surgery - if possible.
- Ensuring peace, recumbency while waiting for an ambulance.
- Refusal from the use of water, food, medicines, painkillers.
Following the tactics of behavior will not harm, to preserve health. An early appeal to specialists will relieve an attack of appendicitis without developing aggravating conditions.
It is important to monitor health, try to follow the principles of good nutrition, daily routine, healthy, full sleep. Strong immunity, physical form, physical activity will significantly improve the quality of life, feel vigor and fullness of energy. A healthy body is able to cope with the onset of infection on its own, preventing the development of the disease, complications and long treatment.
Do I have appendicitis?
Before you call an ambulance or think that everything will pass, you need to check all the signs that indicate appendicitis. When an appendix becomes inflamed, pain first appears in the middle region of the abdomen, concentrating near the navel, after which it is found in the iliac-inguinal region on the right.
When pressing on the abdomen, especially the one where the appendix is located, pain may occur. Such a feeling is a reason to call an ambulance. Suspicion of appendicitis is resolved by pressing and abruptly releasing the hand from the ilio-inguinal region. A sharp pain in the abduction of the hand - a greater percentage of the likelihood of appendicitis.
A hard and elastic abdomen, hard pressed by pressing with a finger, also testifies to the development of the inflammatory process in the appendix.
If a walk with a straightened back fails due to painful sensations in the abdomen and the most comfortable person feels lying on the right side in a bent position, the suspicion of possible progression of appendicitis is confirmed.
A complete set of suspicions is complemented by increased painful sensations during the exertions or coughs. Finally, the displacement of pain from the middle of the abdomen to the ileo-inguinal region during half a day or one day suggests that it is inevitable to remove the inflamed appendix.
It is necessary to know that appendicitis is accompanied by chills, as the temperature rises: from subfebrile (about 37 ° C) to high. Different patients have symptoms that are not necessary for this disease. These include nausea, vomiting, diarrhea or constipation. Many patients can not stop shaking, lack of appetite, a feeling of gassed intestines, the urge to release the rectum (although they turn out to be false).
If the diseased are children or women, the mechanism of the course of the disease may differ from the generally accepted one. Vomiting may appear before the onset of pain, urination causes pain, localization of pain is non-standard: in the back, the area of the anus, the epigastric region, etc.
Several can not with appendicitis
While the ambulance doctor has not diagnosed, it is not worth giving up appendicitis completely. If time still suffers, then you can observe the development of symptoms, so that you are more likely to believe in inflammation of the appendix. At high temperatures, the waiting position should be kept to a minimum. Before the ambulance arrives, it is necessary to learn a few rules, the violation of which will aggravate the situation and cause complications.
You can not do the following:
- take painkillers, as the pain pattern is blurred, and this symptom is the main symptom if there is a suspicion of developing appendicitis,
- take laxatives so as not to irritate the already inflamed intestines,
- eat food, drink before arrival and doctor’s examination,
- apply a hot water bottle, the inflammation only increases,
- postpone the call of the ambulance brigade even when the pain gradually subsided,
- put an enema due to the increasing pressure on the intestines and the danger of opening the appendix with subsequent progress of peritonitis.
What to do before the arrival of the doctor?
The complex of measures to prevent complications after appendicitis or its perforation is reduced to the following:
- The patient minimizes movement and tries to lie in bed, taking a comfortable position for him (on the right side, with legs tucked in).
- The area of pain can be cooled, where you should put a cold heating pad or ice. The speed of the inflammatory process will decrease.
- If during the day the patient did not have the opportunity to eat and drink, then sometimes you can drink cold tea in a teaspoon. You can not eat the patient, but with an overwhelming feeling of hunger, you can eat a few spoons of mashed potatoes.
- Little by little, the patient can begin to eat, if the body temperature returns to normal, the pain subsides and the nausea disappears. In this case, the diet will be the same as after appendectomy: first, protein water, then broths and mashed potatoes.
By the arrival of an ambulance doctor, the patient must be helped to collect things for hospitalization; after the operation, it will take some time to undergo in-patient treatment. On call 03, it is necessary to clarify the urgency of the measures, indicating suspicion of appendicitis.
How to behave when visiting an emergency doctor?
Even with obvious signs of inflammation of the appendix, the doctor must first examine the patient and collect anamnesis. It is advisable to describe the time of the first pain, the whole nature of the development of symptoms. The doctor must feel the patient's abdomen to find out what stage the inflammation is and the degree of integrity of the appendix. Emerging pain during palpation clarifies the clinical picture for the doctor. In some cases, a doctor can study the peritoneum through the rectum. The rest of the diagnosis is carried out in the clinic, where the patient is sent.
To identify acute appendicitis, it is not necessary to do numerous tests. It is enough to pass a blood test and urine. A blood test shows how much the inflammation has spread. Usually in patients with appendicitis, the number of leukocytes in the blood increases to 10-17 thousand per 1 mm3. After opening the process, the number of leukocytes exceeds the upper mark in acute appendicitis and indicates peritonitis. When the number of blood leukocytes exceeds the norm for the inflamed process, and the initial signs of the disease, it is assumed that there are other diseases, for which additional tests are carried out.
A blood test for suspected appendicitis takes into account the state of the leukocyte blood count, the shift of which occurs to the left. This means that there are more young leukocytes in the blood than in a healthy state.
Urinalysis reveals the content of red blood cells, which can occur in renal stone diseases.
After examining the biological fluids of the patient may be sent for additional research on x-rays. To conduct an X-ray examination is necessary when the history is collected superficially, in the symptoms there is no clear definition of the disease. For women, after a blood and urine test, they can take a pregnancy test to rule out an ectopic pregnancy. The atypical picture of appendicitis after examining liquids may require an ultrasound intervention, in which the hypoechoic structure of the oblong shape and the absence of peristaltic movements indicate inflammation of the appendix.
The specified mechanism of action when detecting signs of appendicitis will protect the patient from perforation of the appendix and inflammation of the peritoneum (peritonitis) and will not allow a dangerous disease with a high proportion of lethal outcome - sepsis.
How to recognize appendicitis?
The main symptoms of inflammation of the appendage of the cecum include:
Dull throbbing pain in the navel or at the top of the abdomenwhich may not stop for several hours. Some time after it appears, it begins to shift to the right, and it can immediately appear only in the right side.
At rest, the pain subsides, becomes background, but immediately increases with physical activity - bending, running, fast walking, contraction of the abdominal muscles during coughing, sneezing, laughing, crying.
In older people who carry appendicitis, the pain may be less pronounced and almost not felt.
Suspicion of an inflammation of the appendix should cause any sharp or not long-lasting pain in the abdominal cavity, since the appendix can be located atypically, and the pain can be given to neighboring organs.
Persistent nausea and vomitingthat accompany the whole process of inflammation. They occur after the appearance of the main symptom - abdominal pain.
Heat body that signals about inflammation. As a rule, it does not rise above 38.5 degrees, but most often holds between 37 and 38. A sharp rise in temperature to 39–40 degrees is a signal of the onset of a progressive stage of inflammation and signals the need for immediate surgical intervention.
Dry mouth, dry mucous membranes, white on the tongue allow to clarify that the patient suffers from inflammation of the digestive system.
Diarrhea or, conversely, constipation, can occur only with an atypical course of the disease - for example, with the unusual location of the appendix.
The presence of at least two of these signs gives rise to suspect appendicitis. Symptoms can vary, the patient also has general fatigue, drowsiness, loss of appetite, sleep disturbances due to pain.
Forms and types of appendicitis
Depending on the symptoms and the course of the disease, there are several types and forms of the disease.
1. Catarrhal appendicitis (simple form) is weak, almost does not cause discomfort, therefore it is difficult to diagnose. Pain is not clearly localized, the temperature is within the normal range or rises slightly. If inflammation is not detected in time, the disease proceeds to the next stage, with more pronounced signs.
2. Phlegm form - the most common and giving a clear understanding that we are talking about inflammation of the appendix. Observed pain in the right side, dry mouth, feel sick, the temperature rises to 38 degrees.
3. Perforated form associated with blocking the entrance to the appendage, which is why peritonitis develops. Fecal stones or other substances limit movement in this area of the intestine, inflammation begins, large doses of toxins are released, which makes the patient's condition worse. Nausea, pain, weakness and other signs of poisoning are observed.
4. Gangrenous form - the most dangerous type of appendicitis, since only general symptoms of severe intoxication of the body are observed when it is found; it is rather difficult to establish the cause. At the same time, if the operation is not performed within 1-2 days, there is a threat of rupture of the appendix and the release of its toxic contents into the abdominal cavity - this threatens the patient with a fatal outcome.
Any of these forms of appendicitis can be diagnosed and cured with timely visit to a doctor.
False anxiety - appendicitis-like illnesses
All the above symptoms do not necessarily mean the presence of inflammation of the appendix in the body. The following symptoms have similar symptoms:
- Inflammation of the cyst of the right ovary in women
- A stomach or intestinal ulcer,
- Acute cholecystitis,
- Cystitis and other kidney inflammations,
- Infectious diseases of the gastrointestinal tract.
Correctly diagnose the disease can only specialist. If appendicitis is suspected, it may be necessary not only an examination with palpation, but also an ultrasound scan, a general blood test and an ultrasound diagnosis. Therefore, at the slightest suspicion of inflammation of the epididymis, one should not self-medicate - immediately consult a doctor.
Dangerous signs of appendicitis
Diagnose severe development of the disease can be on some distinctive features. These symptoms indicate the presence of peritonitis and the expiration of pus into the abdominal cavity.
The most dangerous are:
- Silent pain. This feature is considered very serious. When the pain subsides for 3-4 hours, then the risk of rupture of the appendix increases significantly. This is due to the fact that nerve impulses do not enter the head.
- If the pain has resumed again and is growing with great force, and painkillers do not help, then the contents of the appendix began to spread and affect the adjacent tissues and organs, developing peritonitis.
- Severe intoxication of the organism is also caused by the presence of peritonitis. At this point, the person experiences strong gagging urges that do not recede. Excess vomiting brings no relief to the patient.
- A sharp rise in body temperature to maximum performance, or vice versa.
- Excessively tight belly, which excludes any bursting. At the same time when you press there are severe pain.
A death is inevitable if the patient has long suppressed symptoms and consumed medications.
In this case, the course of complications and rupture of the process occur in very muffled tones, which is difficult to determine appendicitis.
What can and can not be done with acute appendicitis
First of all, you can not self-medicate. This is fraught with serious consequences, which will then be very difficult to eliminate.
It is very important to call an ambulance at the first symptoms or to get to the hospital when you can.
Waiting for the doctor, no need to waste time and panic. You need to observe your condition and the development of symptoms.
If you suspect appendicitis can not:
- Take painkillers and antispasmodics. This can greatly spoil the overall clinical picture and be misleading.
- It is not recommended to eat and drink.
- Put laxative drugs and especially enemas. This can be a serious irritant. Such an action can also cause transient rupture of the appendix.
- Warm up the place with pain. Any heat exposure can accelerate the inflammatory process.
- Postpone the ambulance call when the pain and other symptoms subside. On the contrary, the pain may be reduced if the contents have already been ejected inside.
Upon arrival, the doctor will certainly conduct an inspection. He will also need as much information from the patient as possible to make a diagnosis.
The patient should already have collected the entire set for hospitalization. There is also a list of activities that will help eliminate further complications:
- If there is a crazy feeling of hunger, then the patient is allowed to drink sometimes cold tea and 1 teaspoon or eat a few spoons of mashed potatoes with potatoes.
- The pain is less felt if you lie on the right god and pull your legs. You can not engage in physically active affairs - only bed rest.
- It is impossible to warm the inflammation, but it is quite possible to cool it. This will slow down the process of inflammation and reduce the risk of rupture. You can use a cold heating pad or just attach any frozen product in a rag.
- The patient is allowed to eat only after all the symptoms disappear. But even in this case it is necessary to follow a certain diet.
The doctor begins to diagnose the disease on arrival at the patient's home. Initially, he must create a clinical picture, collect all the information and determine the nature of the development of symptoms.
Patient's palpation is considered obligatory. This will help the specialist to find out to what extent the inflammatory process is and whether the appendix has burst.
Sometimes you may need to study the peritoneum through the rectum. Further diagnosis is carried out in the clinic.
No special procedures are required. Blood tests and urine will suffice. A blood test will make it clear to experts how much the inflammation has spread.
When appendicitis, the number of leukocytes increases to 17 thousand per 1 mm cubic. If there is a gap, the mark rises to the highest level.
These increased leukocyte counts in the blood indicate the presence of peritonitis.
With a large number of leukocytes, not suitable for inflammation of the appendix, may indicate the appearance of other diseases. In this case, additional tests are required.
Very important in the analysis of blood and leukocyte formula. When appendicitis, it is shifted to the left.
Such a movement occurs if there are more young leukocytes in the blood than in a healthy state of the body.
Urine examined on the number of red blood cells. Similar can occur with kidney disease.
If you need additional examination, then appoint an x-ray. The need for such an examination is present if the clinical picture is not clear and the symptoms do not give a clear definition.
Women may need a test for pregnancy. This will help eliminate ectopic pregnancy.
When atypical forms of the disease may resort to ultrasound. The hypoechoic structure of the oblong shape and the absence of peristalsis of the movement indicates with precision the presence of an inflammatory process in the appendix.
Such procedures in many ways will allow to secure the patient's condition.
What disease have similar symptoms with appendicitis?
If you suspect appendicitis, it will be very important to know which diseases have similar symptoms. These are pathologies:
- Cystitis and other inflammations of the genitourinary system.
- Inflammation of the cyst on the right ovary in a woman.
- Ulcer diseases.
- Infectious diseases in the digestive tract.
- Acute cholecystitis.
- Any kind of poisoning.
- Inflammatory processes of the abdominal cavity.
- Ectopic pregnancy.
- Internal bleeding due to other diseases.
- Intestinal obstruction.
- Intestinal and renal colic.
- Gynecological pathology.
- Inflammation of the pancreas.
- Intestinal infection.
- Acute and severe neurological disorders, and the presence of a panic attack.
- Inflammation of the testicle in men.
- Inflammatory processes in the nodes of the small intestine.
All this can only be detected or excluded by an experienced specialist. For this purpose, various diagnostic methods are performed already being in the clinic.
Fever at elevated temperature, pain, flatulence and other symptoms that cause discomfort, are standard in the usual development of inflammation of appendicitis.
But it should be noted that some moments may not cause such symptoms. Appendicitis is difficult to determine if:
- HIV infection.
- Cancer tumor.
- People after organ transplants may also have signs of appendicitis.
- Difficult to diagnose and infant or old age.
At the first suspicious symptoms do not need to delay with going to the doctor. Self-medication and taking any medication may adversely affect the patient's future condition and cause severe complications.
Prevention and treatment of appendicitis
Completely protect yourself from the appearance will not work.There are only certain measures that are recommended to be taken to prevent and reduce the risk of developing inflammation:
- Alternate animal proteins with milk proteins.
- The daily menu is recommended to include more vegetables and fruits.
- Avoid overeating.
- Time to start treatment of the digestive tract. If possible, avoid them at all.
- Eliminate constipation and especially applies to chronic.
Treatment refers to the removal of the inflammatory process. The operation itself is not complicated and fast.
If surgery was performed on time, the risk of complications is minimized.
Typically, patients do not spend more than a week in the hospital after surgery. Wounds heal quickly and very rarely can be infected if all the rules were followed during removal.
After removal of appendicitis, some time is needed to protect oneself from physical exertion, and also to follow a diet.
For the most part, pay attention to vegetables and fruits rich in fiber, so that the stool is liquid and gently passes to the exit without irritating the mucous walls of the intestines.