Appendicitis occurs when the appendix becomes inflamed and fills with pus. How to identify appendicitis? Monitor your symptoms.

Step One: What Symptoms You May Occur at Home

Step Two: Look for Other Symptoms of Appendicitis

It is not necessary that you will have all the symptoms. But even the presence of several is a reason to see a doctor.

• Fever - If your temperature is 38 or more, contact your doctor immediately.
• Chills;
• Constipation. If constipation is combined with frequent vomiting, then this convincingly indicates appendicitis;
• Diarrhea;
• Nausea;
• Vomit;
• Back pain;
• Tenesmus (false, painful urge to defecate)

Step three: if you still doubt that you have appendicitis, then find out what not to do

1. And so, if your temperature is 38 or higher, then clearly what you should not do is wait, you should call a doctor.
2. It is strictly forbidden to take laxatives and painkillers.
3. Don't accept antacids. They can also aggravate the pain associated with appendicitis.
4. Avoid eating foods that may cause stomach irritation. Stick to the same diet you eat in recovery period after suffering from the flu.

Step four: you have every reason to believe you have appendicitis, then simply pick up the phone and call an ambulance

1. When the ambulance arrives, describe all your symptoms. Pay attention to any abnormalities, whether constipation, diarrhea or vomiting. Try to tell your doctor when you first noticed the pain.
2. Be prepared for your doctor to palpate your abdomen to rule out peritonitis. If peritonitis is suspected, the abdominal muscles will be severely spasmed. The doctor may even perform quick rectal exams.
3. Additional diagnostic tests: A blood test, abdominal CT scan, or ultrasound may be prescribed by your doctor to confirm the diagnosis of appendicitis.

Adviсe

Most serious complication Appendicitis is the rupture of the appendix and the release of contents into the sterile abdominal cavity, resulting in peritonitis.

Babies with appendicitis sometimes have feeding problems and may seem unusually sleepy. They very often refuse to eat, even their favorite dishes.

People with the following conditions may not have the classic symptoms of appendicitis. Although symptoms such as fever, abdominal pain, bloating are common, such people may only feel general condition fatigue and discomfort. Symptoms of appendicitis are almost impossible to detect in a timely manner in people:

• With HIV infection;
• Obesity;
• Diabetes;
• Cancer;
• In patients after organ transplantation;
• Pregnant women (risk is highest during the third trimester)
• Babies;
• Elderly people;

Causes of appendicitis

The reasons for it have not been sufficiently studied.

The disease refers to inflammatory processes:

Development inflammatory process in the shoot are caused by microorganisms: Escherichia coli, staphylococci, streptococci and microorganisms that live in the absence of air (anaerobes).

Quite often the appendix becomes inflamed after gastrointestinal overload a large number protein foods, especially after holiday overeating.

Contributes to the occurrence of disease and sedentary lifestyle life.

Prevention of appendicitis

• Animal proteins must be alternated with easily digestible proteins from dairy products.
• Include in food ration a sufficient amount of vegetables and fruits. It is especially necessary to avoid overeating.
• The prevention of gastrointestinal diseases and, in particular, is of great importance in prevention.

Although mortality from appendicitis has decreased significantly in recent years. But!

Warnings!!!

Never delay calling an ambulance if you have even the slightest suspicion of appendicitis.

A ruptured appendix can lead to death.

If the symptoms of appendicitis become more intense, then complications may have already begun.

Pay attention to the symptoms of appendicitis and remember that the disease can be life-threatening!

By number acute conditions requiring immediate surgical intervention, appendicitis is in the lead - infectious inflammation vermiform appendix of the cecum. The disease is not always accompanied by “classical” signs known to almost every adult; sometimes clinical picture erased or resembles a completely different pathology. Delay in providing medical care is fraught with serious complications, of which diffuse peritonitis is considered the most dangerous.

The vast majority of cases occur among middle-aged adults, and pathology is often detected in pregnant women. Children over five years of age are at risk. But the younger kids age group suffer from this disease less often, which is explained by the characteristics anatomical structure Gastrointestinal tract.

Since in old age the human body undergoes destructive changes, symptoms acute appendicitis in people over 60 years of age it may be blurred, which makes diagnosis difficult.

In some cases, signs of inflammation of the appendix may occur in patients who have previously undergone appendectomy.

The first heralds of acute appendicitis

Symptoms of acute inflammation of the appendix correspond to the stages of the disease.

Firstly, the first twelve hours are during the catarrhal stage.

The classic first signs of appendicitis begin with general discomfort and slight pain in the stomach area, umbilical region. Nausea sets in almost immediately. Vomiting in 20–40% of cases occurs once and, since it is a reflex mechanism, in older people the urge to vomit may be absent. The pain is dull at first, not so intense, so it is often attributed to a common stomach upset.

With a typical location of the appendix, after 2–4 hours the pain focus moves to the right iliac region; the nature of the painful shocks changes: a pressing sensation and pulsation appear. The intensity increases. During this period, stool disorders and frequent urination are possible. This is followed by fever, often low-grade, ranging from 37.2 to 37.5 degrees.

The following hours of the catarrhal stage are characterized by typical manifestations general intoxication:

• drying out of the mucous membranes of the nose and oral cavity;
• weakness;
• malaise;
• rapid heartbeat;
• lethargy.

Painful attacks intensify and become longer; the patient takes a forced position, trying to reduce the level of pain.

When palpated, the abdomen during this period remains soft and relaxed, but touch causes severe pain.

Unfortunately, most people who encounter the first signs of appendicitis are in no hurry to seek help. medical assistance, losing precious minutes and hoping for “maybe.” As a result, the patient often arrives at the stage of peritonitis, when there is simply no talk of gentle laparoscopic intervention; abdominal surgery is required.

Secondly, the next twelve hours, equivalent to the second half of the first day of the disease, belong to the phlegmous stage.

The pain syndrome intensifies and is clearly visible with right side lower abdomen. Nausea becomes constant, severe tachycardia appears. The temperature rises, jumping over 38 degrees. On palpation, you can feel a tense anterior abdominal wall. It is at this stage that all diagnostic techniques for determining appendicitis become positive.

The maximum number of cases of surgical intervention is performed at the phlegmous stage.

Thirdly, the next second or third day from the moment the first symptoms appear is associated with gangrenous appendicitis.

This stage is characterized by a decrease in pain, giving the patient a feeling of imaginary relief. Similar phenomenon caused by necrosis of the nerve endings of the appendix and, as a consequence, loss of sensitivity in the inflamed area. Along with a temporary decrease in local pain attacks, the symptoms of general intoxication of the body increase. Tachycardia intensifies, the patient is haunted by the urge to vomit, and a whitish coating appears on the tongue. The fever suddenly disappears, and in some cases the temperature drops even beyond 36 degrees. The abdomen is swollen, reacts sharply to palpation and any touch to the skin. The abdominal muscles stop contracting.

Fourthly, the end of the third day and the subsequent time refer to the perforative stage.

Painful tremors merge into one continuous attack. Nausea becomes more pronounced, vomiting occurs repeatedly. At the moment of rupture of the walls of the appendix, the patient feels sharp pain, which quickly grows and is localized in the right iliac region. Tachycardia increases, the color of the coating on the tongue changes color, becoming brown, the stomach swells even more. Delay in seeking medical help ends in diffuse peritonitis, in some cases - an isolated purulent focus. If at this stage the patient does not reach operating table, the disease will end in death.

Unfortunately, the pathology does not always develop according to the classical stages: many cases of fulminant appendicitis have been registered, and hidden variants of the disease also occur. In some cases, the disease is skillfully “masked” as other ailments or, on the contrary, the symptoms of inflammation of the appendix refer to lesions of other organs.

How to recognize appendicitis in a child

Despite the immaturity of the gastrointestinal tract structures, inflammation of the appendage of the cecum can also occur in a child of a younger age group. If children who can speak and express their feelings can report a problem, then for infants parents only have to guess.

You should immediately go to the nearest hospital or call an ambulance if you have the following symptoms:

• the child stops moving, preferring to sit or lie in a forced position;
• temperature rises without symptoms respiratory infection accompanied by nausea, vomiting;
• the child does not allow touching the stomach, pushes away hands, screams;
• the baby even refuses his favorite food and treats;
• mucous membranes become dry;
• pulse and breathing increase;
• the baby convulsively presses his legs to his stomach and expresses concern in every possible way.

The combination of these signs gives reason to worry and suspect not only appendicitis, but also another disease with similar symptoms, for example, intussusception.

The first signs of inflammation of the appendix in old age

Since patients who have crossed the threshold of 60 years often experience destructive changes, and the body reacts to the disease less actively, the clinical picture is mild. The classic signs of an infectious lesion of the appendix are blurred, which makes it difficult to make a correct diagnosis and determine the exact location of the source of the disease. In some cases, symptoms include flatulence and difficulty defecating.

Any painful sensations in the abdomen in children or the elderly, especially when accompanied by other signs of appendicitis and aggravated by movement or coughing, become a reason for an immediate visit to the doctors.

So, your stomach hurts. What could it be? Simple indigestion intestinal infection or appendicitis, which without timely treatment can lead to death within a few days? How to determine appendicitis at home and is it really possible to suspect such a terrible disease at home?

Appendicitis is an inflammation of the vermiform appendix of the cecum (appendix). It can be either acute or chronic. The cause of the disease is both microorganisms, viruses, and various allergens that can provoke a local inflammatory process. As a rule, appendicitis is treated surgically.

How to suspect acute appendicitis

In children younger age Appendicitis usually begins gradually and progresses over several days. Such children suddenly squat down and start crying.

And for children over 7 years of age, the leading symptom of acute appendicitis is pain, mostly dull and constant. It can begin anywhere, but after some time it usually moves to the area of ​​​​the projection of the cecum (in bottom part right half abdomen - right iliac region). , then the projection of the cecum will often (not always) be on the left.

The pain with appendicitis is moderate and forces a person to lie down in bed, turning on his right side. Walking, movement, coughing, laughing, sneezing increase the feeling of pain.

Sharp and sudden pain may indicate a perforation of the appendix, and subsidence painful sensations- about development already gangrenous appendicitis, which is fraught with the most dangerous complications.

They may cry, be restless and point at their stomach. When trying to touch last child, as a rule, protests, his crying intensifies. The onset of appendicitis in young children is gradual. During the day, such babies may suddenly squat down and cry, and at night wake up in pain.

The next most common symptoms of appendicitis are nausea and vomiting. In adults and older children it occurs 1-2 times, and in children it can be repeated. It is believed that with inflammation of the appendix, nausea and vomiting are reflexive in nature.

In older people, pain and nausea may not be as severe, and this circumstance in some cases leads to a delayed diagnosis of appendicitis.

Appetite is reduced or completely absent.

Palpation of the right iliac region of the abdomen can reveal local tension in the muscles of the anterior abdominal wall. However, you should not do this yourself, so as not to harm the patient.

Other symptoms of appendicitis can be very diverse, observed in some and opposite in others. Let's look at some of them in more detail:

• Chair. With the typical location of the appendix in adults and older children, the stool is normal. Diarrhea or constipation may occur in young children and atypically in adults. Rapid loose stool against the background of vomiting and elevated temperature may lead to unnecessary hospitalization in the infectious diseases department.
• Temperature. In the elderly, as well as children who are on breastfeeding, the temperature may be almost normal at the beginning of the disease, which does not at all indicate feeling good. Very high fever is observed in children and as the disease progresses in adults. In typical cases, the most typical increase is up to 37-38 0 C.
• Other symptoms. If the appendix is ​​located closer to the pelvic organs or urinary system, then appendicitis is accompanied by lower back pain and frequent, painful urination with irradiation of pain to the external genitalia. In the elderly, as inflammation of the appendix progresses, various chronic diseases(diabetes mellitus, hypertension etc.), which can blur the picture of appendicitis. Children may react with “cold symptoms,” such as a runny nose.

Chronic appendicitis

Occurs predominantly in adults and is quite rare disease. Characterized by periodic pain in the right iliac region. With exacerbation of the disease, perforation of the appendix and peritonitis may occur. Symptoms are almost the same as for acute appendicitis, but may be less pronounced (especially the temperature reaction).

Things to remember

Abdominal pain, fever, constipation or diarrhea, frequent painful urination and other signs can also occur in other diseases, which only a specially trained person can understand. In this regard, there is one rule that will help to diagnose appendicitis in a timely manner, especially in children: if your stomach hurts, do not self-diagnose: see a surgeon.

Appendicitis is inflammatory disease vermiform appendix of the cecum (appendix). Among pathological conditions abdominal cavity in terms of recognition, it can be either the easiest or the most difficult. Let's consider the most typical symptoms appendicitis in adults.

Acute appendicitis

Small, cecum and large intestine, vermiform appendix (appendix). On the left - normal, on the right - appendicitis.

In acute appendicitis, inflammation of the appendix develops in stages, moving from one stage to another:

• Catarrhal appendicitis. The inflammatory process occurs only in the mucous membrane of the appendix.
• Surface. Inflammation progresses, resulting in the formation of primary damage to the mucous membrane. At this stage, not only leukocytes, but also blood are found in the lumen of the appendix.
• Phlegmonous. All layers of the appendix become inflamed, right down to the outer shell.
• Phlegmonous-ulcerative. Ulcers form on the mucous membrane of the appendix.
• Gangrenous. Necrosis of the wall of the appendix, often a breakthrough of the contents into the abdominal cavity and the development of subsequent peritonitis. At this stage, the mortality rate from this disease is highest.

In most cases, from the first to last stage It takes about 2 days, so acute appendicitis is a disease in which you cannot postpone a visit to the surgeon: starting with phlegmonous appendicitis, the risk of complications increases sharply.

Let's look at some of the signs of acute appendicitis in more detail.

Pain. As a rule, from the very beginning there is a dull constant pain in the navel or upper abdomen. In some cases, it may spread throughout the abdomen or appear immediately in the right iliac region. Usually worsens when walking, bending the body, as well as laughing and sneezing. Older people may not feel it at all.

If the appendix is ​​located atypically, then the pain can be anywhere: in the suprapubic region, in the right hypochondrium, in the area of ​​​​the projection of the kidneys or ureters, with irradiation to right thigh, external genitalia or lower back. Sometimes it even hurts on the left.

After a few hours, the pain gradually moves to the place where the vermiform appendix is ​​located. If it suddenly disappears completely, then this may indicate the death of nerve endings and the development of gangrenous appendicitis.

The leading symptom of this form of appendicitis is recurrent pain, which intensifies with body movement. During the period of exacerbation, the symptoms resemble the course of acute appendicitis, but against the background of normal or slightly elevated temperature. The main danger during an exacerbation is the development of peritonitis. Therefore, you urgently need to see a doctor who will help you adequately assess the severity of the condition.

Conclusion

Leading symptoms of appendicitis.

Due to the fact that the main thing in the treatment of appendicitis is timeliness, it is necessary to urgently consult a doctor in the following cases:

1. Abdominal pain that does not go away and gets worse when coughing, moving, or walking. Over time, it can move to the right iliac region or be localized in any part of the abdomen or lower back.
2. Fever, constipation or diarrhea, nausea or vomiting.
3. When you gently touch the abdominal muscles, you can feel their involuntary tension.

This is interesting

There is a known case when in Antarctica, during an expedition in 1961, a doctor, Leonid Ivanovich Rogozov, diagnosed himself with acute appendicitis (nausea, fever, pain in the right side). Attempts conservative treatment(fasting, cold, antibiotics) were unsuccessful and therefore the decision was made to perform an immediate operation. The problem was that Leonid was the only doctor on an expedition, and therefore he had to perform the operation on himself. The mechanical engineer held a mirror to his stomach, and the meteorologist handed over the tools. The operation lasted 1 hour 45 minutes, was successful, and after 7 days the doctor removed the stitches and began performing his duties.

Which doctor should I contact?

If the symptoms described above appear, you should immediately contact medical institution or call " Ambulance" The patient is being treated in a surgical hospital. Before the operation he is examined by an anesthesiologist, a therapist, and in cases of severe concomitant pathology(for example, recently suffered a heart attack myocardium or decompensated diabetes mellitus) - specialized specialists.

Popular doctor about acute appendicitis:

Inflammation of the appendix of the cecum, known throughout the world as appendicitis, is the main cause of all urgent surgical operations. The signs of acute appendicitis are known to almost every adult, but this pathology has several stages and varieties, each of which has its own special symptoms. How to recognize inflammation of the appendix in children and adults in time and prevent dangerous complications this seemingly simple disease?

Manifestations of appendicitis in adults

To understand how appendicitis manifests itself in adult patients, it is enough to know a few basic symptoms. However, in each person, inflammation of the appendix can occur differently, depending on age, immunity, and the anatomical location of the appendix itself.

In most people, acute appendicitis begins with the following symptoms:

• Pain is the first and main symptom intestinal inflammation. It occurs unexpectedly and without visible reasons in the upper abdomen or in the navel area, gradually moving to the right iliac region. Initially, the pain is dull, then intensifies.
• Weakness and lethargy, loss of appetite, problems sleeping due to abdominal discomfort.
• The temperature can rise to 37-38°C, the patient's pulse increases to 80-90 beats. In some cases - chills.
• The patient suffers from nausea, which may be accompanied by one or two vomiting (in 20-40% of patients), a yellowish-colored appearance appears on the tongue. white coating.
• Lying on the left side discomfort in the abdomen intensify, so the sick person instinctively lies on his right side.

Manifestations of appendicitis in children

Signs of acute appendicitis in children after 7 years of age usually coincide with the classic symptoms of the disease in adults. In young children, the disease begins abruptly and develops very rapidly.

The first signs of inflammation in babies are screaming, crying, refusal to eat, bad dream, an instant increase in temperature to 38-40°C. In rare moments of calm, children try to lie in one position without moving.

In older children, inflammation of the appendix can be recognized by the following symptoms:

• Abdominal pain of different localization (in the upper part, in the navel, on the right or throughout the entire abdomen).
• Anxiety (weakness, moodiness, poor appetite, sleep problems).
• The temperature instantly jumps to high numbers.
• “Toxic scissors” syndrome (with an increase in temperature by 1 degree, the pulse increases by 8-10 beats per minute).
• Abnormal bowel movements (constipation or diarrhea), bloated tummy.
• Nausea, vomiting, white coating on the tongue.
• In young children under 3 years of age, inflammation of appendicitis can cause pain when urinating.

Manifestations of appendicitis at different stages

Inflammation of the appendix is ​​progressive: signs acute pathology are largely determined by the stage in which the disease is located.

The catarrhal stage lasts the first 6-12 hours from the onset of inflammation

The main symptom of this form of appendicitis is discomfort and pain in the abdomen, which intensifies at night, when coughing/sneezing and when lying on the left side. Patients suffer from nausea and may vomit once. The temperature rarely rises, usually no higher than 38°C.

The purulent phlegmonous form develops before the end of the first day of illness

The pain is finally localized in the right lower abdomen, the patient constantly feels nauseous, the pulse quickens, and the temperature remains stable at 37-38°C.

The abdomen is very tense; upon palpation it is easy to detect all the main diagnostic symptoms inflammation of the appendix.

The gangrenous stage continues for the second or third day

Pain subsides due to death nerve cells appendix begins severe intoxication: nausea, vomiting, dry mouth, tachycardia. The abdomen is swollen, stool is completely absent.

Perforated stage

A rupture of the appendix wall is accompanied by severe pain, which rapidly increases. The vomiting does not stop, the abdomen is swollen and tense, there is no stool, the temperature rises to 40°C and above.

Manifestations of atypical forms of appendicitis

Atypical forms of acute appendicitis are usually associated with a non-standard location of the appendix in the abdominal cavity and are quite rare. Making a diagnosis in such cases is difficult, so the risk of developing purulent forms and severe complications is high.

The retrocecal variety occurs in 10-12% of patients. With this diagnosis, pain is felt in the right side of the abdomen, can move to the lower back and radiate to the right thigh when walking. There is practically no nausea and vomiting, the stool is semi-liquid, mixed with mucus. The temperature rises from the first hours of inflammation.

Pelvic appendicitis is diagnosed in 5-20% of patients, mostly adult women. The pain is concentrated in the lower abdomen and can radiate to the groin or navel. Urination is frequent and painful, loose stools with mucus occur several times, temperature and signs of intoxication of the body are almost not expressed.

With medial appendicitis (8-10% of cases), all symptoms are pronounced - excruciating pain on the right or in the navel area, fever, repeated vomiting, strong tension peritoneal muscles, intestinal obstruction.

The chronic form is characterized by periodic attacks of pain; during moments of exacerbation, all the classic signs of acute inflammation can appear.

Pain in acute appendicitis

Discomfort and pain in the abdominal area are considered the main symptoms of acute inflammation of the appendix. Pain with such a pathology is always present, but it can vary in intensity, location and character (dull, aching, paroxysmal).

Typically, classic acute appendicitis begins with a severe attack of diffuse abdominal pain, which gradually moves to the right iliac region. The pain either decreases or intensifies again, but does not completely disappear. If the pain begins to subside 2-3 days after the onset of the disease, this may indicate gangrene of the appendix. Sharp attack by the end of the third day of the disease it can signal perforation of the appendix and lead to peritonitis.

In what place does pain usually appear during inflammation of the appendix:

• In the navel area - the onset of the disease, subsequently pain covers the entire abdominal cavity;
• In the lower abdomen, in the right iliac region - ordinary catarrhal acute appendicitis;
• In the right side or lower back - retrocecal inflammation of the appendix;
• Above the pubis and in the pelvic area - pelvic appendicitis.

Temperature in acute appendicitis

When diagnosing appendicitis important role body temperature plays a role. The first 6-12 hours, at the catarrhal stage, the temperature usually remains at normal levels, in some cases it rises to 37.2-37.8 ° C.

As inflammation develops, the temperature rises to 38.3-38.5°C, with gangrenous form it is possible that it will return to normal levels and even drop to 36°C. At the stage of perforated appendicitis, the temperature usually jumps to 40°C, this is one of the symptoms of incipient peritonitis.

The temperature and severity of the inflammatory process in appendicitis do not always correspond to each other. In most cases, the disease occurs in the first hours with normal temperature body, only some patients (usually children) develop fever. For severe purulent forms pathology, the temperature is also unstable, rising to high numbers or falling below normal.

Diagnosis of appendicitis

Since the signs of appendicitis are varied and appear differently in all patients, put accurate diagnosis Only a doctor can do it. The main tests to determine the nature of inflammation are anamnesis and examination, general analysis blood, urine test, ultrasound, in difficult cases– laparoscopic examination.

There are also home methods that will help identify appendicitis and speed up the patient’s hospitalization. Please note that such self-diagnosis techniques must be used very carefully so as not to provoke a new attack of pain, but late stages- appendix rupture.

1. Tap gently with the pad index finger in the right and left iliac regions - with appendicitis, in the first case there will be pain, in the second - no discomfort.
2. Lie on your right side and assume a fetal position. If the pain subsides in this position, but intensifies when turning to the left side, it is most likely appendicitis.
3. Try coughing and sneezing: acute inflammation appendix pain will increase sharply.
4. Press lightly with your palm sore spot and hold for 10-15 seconds. When the pain subsides a little, remove your hand. If the pain intensifies, this is a signal of appendicitis.

The symptoms of acute appendicitis have been known to mankind for several centuries, but even today, with the most modern methods diagnosis, making a diagnosis can be difficult. Therefore, it is important for every person to know how appendicitis manifests itself in order to consult a doctor in time and have comprehensive diagnostics and prevent such health and life-threatening complications as abscess and purulent peritonitis.