Appendicitis is an inflammation of a scolecoid shoot of a blind gut – an appendix. An inflammation caused by pus-producing microbes which get into appendix with a blood or a lymph. As the reason of disease not digested rests of food corking a gleam of a scolecoid shoot can serve also. Depending on a stage of illness appendicitis subdivide on catarrhal, phlegmonous and phagedenic.
Symptoms of illness
As signal of the beginning of disease is the pain. In the beginning the pain has no precise site – it seems to the patient, that all stomach hurts. But passes 5-6 hours, and the pain concentrates in right ileac areas. We would like to pay your attention to following nuance: an appendix at all features of a structure of a body are located differently, those, and the place of localization of a pain depends on its position. If position of a shoot normal – hurts in right ileac areas if the shoot is located highly, hurts on the right almost under edges if the appendix is unbent back, the patient feels a pain in the field of a waist and if the shoot is lowered downwards, hurts in the field of a basin and above the pubis.
Development of illness
Doctor will define the form appendicitis – idle time of an appendicitis is characterized inflamed by a scolecoid shoot. The body temperature is raised a little, usually no more 37,5C.
If the pain not so strong, and vomiting is not present a nausea (such happens quite often) the patient does not hurry up to address to the doctor. And then idle time of an appendicitis passes in the phlegmonous form. The scolecoid shoot itself is filled with pus, on its surface there are ulcers. Because of ulcers the inflammation starts to extend on the fabrics surrounding a shoot. At this stage of the patient disturb the pains amplifying at a pressure of muscles of a stomach, at thin people the inflamed shoot can even be probed, it will remind the dense platen.
In the worst cases phlegmonous appendicitis passes into the phagedenic form. In this stage the shoot filled by pus distributes an inflammation to all belly cavity. However, patients notice, that pains disturbed them have passed are speaks that nervous cells inflamed a scolecoid shoot were lost. On a place hurt deterioration of the general condition comes. In fact now in inflammatory process all belly cavity is involved. The intoxication of an organism promptly accrues, the patient feels strange euphoria, pulse keeps at a level of 100 impacts in a minute (in norm 65-70), the leather pale to move difficultly, a stomach is inflated.
If to the patient it is not helped, the inflamed appendix breaks – this instant is very painful for the patient, pus spreads on a belly cavity and the life of the patient appears under threat of because of the general infection of blood.
Diagnostics of appendicitis
Appendicitis is complex enough to define – symptoms vary depending on an arrangement of a shoot, and the doctor is deprived an opportunity "to glance" to the patient in a stomach. Traditionally appendicitis diagnose, being based on the given analyses of blood and urine – in blood the quantity white blood bodies increases, and in urine there is a fiber. But diagnostics of appendicitis is not limited to it.
Other type of diagnostics – a computer tomography. Computer tomography also gives the image of the enlarged shoot, the changed fabrics of intestines and abdominal membrane are visible also.
To see the inflamed appendix personally the laparoscopy allows. In a belly wall the small cut into which the fibre-optical tube with a videocamera on the end is entered is done. It is the most authentic method of diagnostics.
Treatment of appendicitis
If the patient acts in a hospital, suffering from a pain, at once nobody will drag it on an operational table. It is connected by that under symptoms of appendicitis illnesses can mask many other things, for example, inflammatory processes in kidneys, at women – inflammations of genitals. Therefore doctors will observe some time behind development of illness, will collect analyses and only then will draw a conclusion on necessity of operative intervention. If it is diagnosed « sharp appendicitis », treatment will be operative. Operation on removal of an appendix is spent by two ways: traditionally and endoscopic.
At traditional operation above the inflamed shoot the cut in length 8-10 see the Surgeon is done cuts a muscle, examines a shoot, and if fabrics surrounding it are not inflamed, an appendix delete, and an aperture in a gut in a place of an attachment of an appendix, sew up.
At endoscopic operations in a stomach of the patient enter a thin tube with the chamber. The doctor sees the image on the monitor. Tools enter through special apertures and delete a shoot under the constant visual control. At endoscopic operations cuts very small, the postoperative period passes much easier and more quickly. The modern surgery is so good, that the patient with not complicated appendicitis write out next day after operation. If the shoot nevertheless was broke off and has begun a peritonitis, it is necessary to lead in a hospital about a week. These days the patient will intravenously receive antibiotics which will help an organism to struggle with development of an infection. When the patient only has acted in a hospital with suspicion on appendicitis, the doctor at once will appoint to it antibiotics (cefazolin, erythromycin and others) is is necessary for the prevention of development of an infection after operation.
Chronic appendicitis
It happens, that the organism of the person possesses so powerful immunity that is capable to suppress the begun inflammation of an appendix by own strength. However, at easing immunity or at strengthening loading on muscles of a stomach the inflammation again « lifts a head ». It is so-called chronic appendicitis – the person periodically has pains in right ileac areas. Chronic appendicitis delivers to the patient weight of inconveniences: each attack of appendicitis threatens with development of a peritonitis, and at each attack it is necessary to address to the doctor. Chronic appendicitis does not demand removal of a shoot, however, if attacks repeat often, the shoot is better for removing.
