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The size of the appendix varies from 5 to 15 centimeters in length, and its diameter is about one centimeter. This disease of the abdominal cavity manifests itself quite often and almost always requires surgical treatment.
There are two forms of appendicitis - chronic (very rare, many scientists generally do not admit the possibility of its development) and acute appendicitis. Acute appendicitis can cause serious complications, including peritonitis, intestinal obstruction, and even sepsis. The main symptom of appendicitis is pain - an attack of pain in the case of acute appendicitis occurs suddenly.
Appendicitis is a fairly common disease. It can manifest itself at absolutely any age. However, it is known that it most often occurs in people between the ages of ten and thirty. The incidence of acute appendicitis is four to five cases per thousand people per year. It is appendicitis that occupies a leading place among abdominal diseases requiring surgical treatment (this disease accounts for almost 90% of cases). Most often, it is acute appendicitis that leads to the development of peritonitis.
Appendicitis is an inflammation of the appendix. It is believed that this disease begins after the opening between the cecum and the appendix is clogged. The cause of the blockage can be either the ingress of feces from the cecum into the process, or in a layer of thick mucus inside the appendix - the mucus or feces harden, as a result of which the hole is blocked (the stones formed in this way are called colors). Another cause is blockage of lymphoid tissue resulting from swollen lymphoid tissue. Finally, appendicitis can be associated with rupture of the appendix, the cause of which is often unclear. The rupture may be due to changes in the lymphoid tissue that lines the inner surface of the appendix.
Pain is the main symptom of appendicitis. The pain covers the entire abdomen, but is more distressing in the upper part. A characteristic feature is the fact that pain in appendicitis does not have a clear localization, that is, the patient cannot accurately show the place where he hurts - in this case, we are talking about indistinctly localized pain. As the suppuration of the appendix increases, it can spread to the peritoneum (through the lining of the abdomen) - in this case, the pain tends to intensify. The patient can already more or less accurately tell where the pain is located. However, if the appendix ruptures and the inner film of the abdomen becomes infected, the pain cannot be localized again. Other possible symptoms of this disease include nausea and vomiting, and fever. The latter is normal. Since it means that the body has begun to fight the infection.
An attack of acute appendicitis begins suddenly. This is most often the case. The pain comes on suddenly. At the beginning of an attack, vomiting often occurs, which, however, does not bring any relief, stool retention is a common phenomenon (by the way, if you suspect acute appendicitis, in no case should you use laxatives and do enemas, since all this can lead to peritonitis). An attack of acute appendicitis is characterized by an increase in temperature of 37.5-38 ° C. A blood test in most cases shows the presence of leukocytosis in the blood, if necessary, a second blood test is carried out - two to four hours after the first analysis. In the initial period of the disease, ESR is usually normal, but later it is usually increased.
The symptoms of appendicitis may disappear. This happens when the inflammation does not cover the abdominal cavity. This situation can be created, for example, by taking antibiotics (but not necessarily). As a result (the disease does not go anywhere), patients can go to medical institutions long after an attack of appendicitis has occurred. They may have infiltration or swelling in the right lower abdomen.
Chronic appendicitis is rare. The main complaints of patients are related to the presence of recurrent pain in the right iliac region. This disease is diagnosed on the basis of a comprehensive routine examination (its purpose is to exclude all other diseases of the abdominal cavity and kidneys), as well as on the basis of anamnesis. The latter in this case includes information about a previous attack of acute appendicitis and the formation of an infiltrate.
Chronic appendicitis is especially difficult to diagnose in childhood. Diagnostics is carried out only in stationary conditions. This is due to the fact that pain may not appear as a result of appendicitis, but with malformations, inflammation of the mesenteric limf, nodes, and also for other reasons. If a thorough examination confirmed the diagnosis of appendicitis, then its treatment is prompt.
Diagnosis of acute appendicitis in children is difficult. This is especially true for children under three years old. In childhood, the clinical picture is approximately the same for all acute inflammatory diseases. The course of acute appendicitis in children is much more difficult than in adults. Interesting statistics on diseases of acute appendicitis. Young children account for about 5% of acute appendicitis diseases, preschool children account for 13% of acute appendicitis diseases, and school-age children - more than 80%.
Appendicitis is the most dangerous during pregnancy. This condition is the most common cause of surgical treatment in pregnant women. One case of acute appendicitis occurs in 700-2000 pregnant women. The difficulty lies in the timely diagnosis of this disease in pregnant women. The complexity is due to the physiological and anatomical characteristics of the female body during pregnancy - as a result, appendicitis gives complications. Early appendectomy in this case can save the life of the mother and child and prevent the development of complications. The main symptoms of acute appendicitis in pregnant women are acute pain. After a while, the pain begins to be aching. At the same time, it has a clearer localization - that is, the pain moves to the right side of the abdomen.
Acute appendicitis can be recognized by checking many of the symptoms. As a result, the clinical picture is clearly emerging. Here are some of the symptoms. The basis of Pszewalski's symptom is the occurrence of difficulty in a patient with acute appendicitis in raising the right leg.
Rizvan's symptom is that the pain in the lower right abdomen increases when taking a deep breath. Rovzing's symptom is associated with the fact that when the sigmoid colon is squeezed, pain either appears (if it was not there), or tends to intensify (if it was). The Shchetkin-Blumberg symptom is positive if the pain increases with a sudden withdrawal of the hand. Sitkovsky's symptom is that the patient, lying on his left side, feels the onset of pain in the right iliac region (if there were none before) or their intensification.
Diagnosis of acute appendicitis can be complicated due to the fact that the appendix in different people has its own peculiarities of location. If the appendix is located retrocecal - that is, behind the cecum - then the abdomen continues to be soft; in accordance with the above, it is difficult to diagnose acute appendicitis. Therefore, it becomes necessary to examine the organs of the chest cavity.
Women undergo a gynecological examination. The latter, along with rectal examination, is very important, since diseases of the pelvic organs have a similar clinical picture with acute appendicitis. And only by excluding diseases of the small pelvis, can we talk about acute appendicitis.
Acute appendicitis is subject to surgical treatment. Diagnosis of this disease is an indication for an emergency operation. If symptoms of diffuse peritonitis are not found, then a McBurney incision is performed. In domestic science, it is called the Volkovich-Dyakonov access. The main stage of the operation is to remove the appendix. Laparoscopic appendectomy is now widespread. Its essence lies in the removal of the appendix through small punctures of the abdominal wall. Punctures (most often there are three) are made using special tools. It should be noted that surgical treatment is carried out if there are no signs of appendicular infiltration. If signs of a formed infiltrate are present, then the patient is assigned bed rest, a diet corresponding to the disease, and antibiotics are prescribed. If the size of the infiltrate increases, then surgical treatment is necessary. It consists in opening the abscess.
If appendicitis is not diagnosed in time, then it threatens with serious complications. Peritonitis is one of these complications. Perforation of the appendix is a very common complication. In this case, the infection from the appendix enters the abdominal cavity. Peritonitis develops. Peritonitis is an acute inflammation of the peritoneum (visceral and parietal). This inflammation has no tendency to delineate. But if the inflammation is of a delimited nature, then they speak of an abscess. An abscess is also called an inflammatory infiltrate - it is also a possible complication in acute appendicitis. Mesenteriolitis is a complication of acute appendicitis, which is an inflammation of the mesentery of the appendix. Intestinal necessity in acute appendicitis is uncommon. This complication occurs when the intestinal muscles stop working. They can stop functioning as a result of inflammation around the appendix.
Sepsis is a dangerous complication of acute appendicitis. Sepsis is blood poisoning. This condition develops as a result of bacteria entering the bloodstream. These bacteria are transported with the eye of the blood to other organs and tissues. True, this complication is quite rare.
The term appendicitis has been in use since the nineteenth century. It was first used in 1886. Then it was discovered that the most effective way to treat this disease is to remove the appendix (appendix). The very operation to remove the appendix - the first in history - was performed in 1888. The first operations took place in Germany and England. In 1889, a clinical picture of appendicitis was compiled. McBurnie described her. Currently, one of the symptoms of the disease bears the name of this scientist, as well as the oblique incision itself, which surgeons perform to get to the appendix. But in practice this cut was applied not by McBurney, but by MacArthur. In the same 1888, a similar operation was carried out in Russia. It was done by the doctor Dombrovsky at the Peter and Paul Hospital. A little later, the removal of the appendix was carried out by the doctor of the Obukhov hospital - Troyanov. In 1909, immediately after the Congress of Russian Surgeons, the operation to remove the appendix began to be carried out more widely.
An interesting fact: in the second half of the twentieth century (in 1961), the surgeon Rozanov performed an appendectomy operation. This event is remarkable in that the surgeon performed it on himself. In the conditions of work in Antarctica, of course, there was no other opportunity.
Eating wholesome food is the main way to prevent acute appendicitis. In general, eating healthy foods reduces the risk of all diseases. In order to avoid the possible development of appendicitis, it is worth reducing the amount of meat eaten, since it is known that people who consume only food of plant origin develop acute appendicitis much less often. Fiber-rich foods help protect the body from appendicitis. Severe complications of acute appendicitis can be prevented by people with chronic appendicitis by performing an operation - then the risk of developing acute appendicitis and its complications will be reduced to zero.