Appendicitis is an inflammation of the appendix of the caecum (appendix).
Acute appendicitis is the most common cause of abdominal surgery. Inflammation of the appendix develops with the same frequency in men and women, more often an attack of acute appendicitis occurs at the age of 10-30 years.
The appendix is a small, blindly ending process of the caecum, which is quite small in humans. In herbivores, this section of the intestine is highly developed and serves to ferment coarse, fiber-rich plant foods. The appendix is usually located in the right iliac fossa – in the lower abdomen on the right. The appendix is not involved in digestion, but plays an important role in the intestinal tonsil: its wall is rich in lymphatic tissue, and the appendix itself is part of the immune system.
Causes of appendicitis
Among scientists and doctors there is no consensus regarding the causes of appendicitis. The most likely cause is considered to be a blockage of the narrow lumen of the process, which leads to inflammatory changes in it. In the appendix, pressure rises, inflammatory exudate sweats into the lumen, and blood circulation is disturbed.
An inflamed appendix becomes an easy prey for intestinal microflora, which can cause its destruction within a day.
Most often, coprolites – intestinal stones – lead to blockage of the appendix, sometimes foreign bodies (helminths, fruit stones, nut shells, seed husks and even dental crowns) become the cause, but these are casuistic cases.
Neoplasms in the area of the appendix, thrombosis of the vessels of the appendix, its kinks, cicatricial deformity as a result of adhesive disease, and so on, become a rare cause of inflammation.
Sometimes the cause of inflammation cannot be determined.
Symptoms of appendicitis
Humanity has been familiar with acute appendicitis since ancient times, this problem has been well studied, the operation to remove appendicitis is the most common in abdominal surgery, but appendicitis is still considered an insidious disease that is not always recognized in time. Acute appendicitis is the most common cause of peritonitis (diffuse inflammation of the abdominal cavity) and is sometimes fatal. Difficulties in diagnosis are associated with a variety and ambiguity of symptoms.
It is especially difficult to detect appendicitis in young children, the elderly and pregnant women: their clinical picture of the disease develops blurred and atypically.. Therefore, all cases of abdominal pain, against the background of temperature and lack of appetite in these groups of people should be a reason for urgent medical attention.
The most common (typical) signs of appendicitis include:
- Abdominal pain usually appears in the upper abdomen or does not have a clear localization, however, within a few hours it migrates to the right iliac region (on the right above the womb), usually aggravated in the position on the right side, with straining, coughing and sneezing.
- Temperature increase up to 37-38 ° C appears in the first hours of the disease.
- Lack of appetite – not specific, but characteristic of appendicitis sign.
- Nausea and vomiting (usually no more than 1-2 times), occurs after the onset of a pain symptom.
- stool disorder: can be both diarrhea and constipation.
Read more: How is appendicitis treated?
Diagnosis and treatment of appendicitis
If these symptoms continue to increase for 12 hours or more, an ambulance should be called.
Of great importance in the diagnosis of appendicitis is the examination and palpation of the abdomen, the identification of symptoms specific to this disease.
If after the examination the doctor has doubts, it can be carried out ultrasound examination of the abdominal organs, x-ray examination, computed spiral tomography. The indicators of clinical blood and urine tests are changing. However, all these methods are not always informative.
In disputable cases resort to a diagnostic laparoscopy. Through a small pinhole on the anterior abdominal wall, a special endoscope is inserted, with the help of which it is possible to see with the eyes what caused the catastrophe in the abdominal cavity. If the diagnosis of acute appendicitis is confirmed and the conditions allow, during this manipulation, the culprit of the disease, the appendix, is also removed. Only tiny scars on the abdomen remain as a memory of the operation.
However, in the case of advanced appendicitis, individual characteristics (atypical location, etc.), it becomes necessary to use other types of surgical intervention.
In most cases prognosis after surgery is good. The frequency of complications during surgery varies from 0.1% to 15% depending on the form of appendicitis and the age group of patients.