Signs and symptoms of appendicitis. Symptoms of appendicitis Dangerous manifestations of appendicitis

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 children over 7 years of age the leading symptom 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 the right half of the abdomen - the 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 the subsidence of painful sensations indicates the development of 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.

On palpation of the right iliac region abdomen, local tension in the muscles of the anterior abdominal wall can be detected. 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 may worsen ( 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 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 severe inflammation cecum in humans. Most often, this disease is observed between the ages of ten and forty years. It is considered the leader in emergency response surgical operations on the abdominal cavity. Let's take a closer look at the signs and symptoms of appendicitis in children and adults, as well as much more.

Most often, acute appendicitis develops for the following reasons:

Important! Doctors believe that the risk of inflammation of the appendix also increases frequent use alcohol and poor diet.

What else provokes the development of inflammation of the appendix, read.

Types and forms of appendicitis

Distinguish following forms appendicitis:

The acute form of inflammation is considered the most common. In this case, the patient will need urgent surgical treatment, since otherwise the inflamed bowel could cause serious complications in his condition.
Chronic appendicitis can develop in both women and men. Its appearance is usually promoted earlier previous illness in acute form. In this condition, the human appendix will experience pathological processes dystrophic in nature.

How not to confuse inflammation of the cecum with appendicitis, read.

Chronic appendicitis can quite long time cause repeated tissue damage, heal and scar again. Also sometimes this form inflammation provokes the transformation of the intestinal appendage into a cyst, which will be accompanied by the accumulation of fluid and the appearance of dropsy. This is a serious condition that requires urgent surgical attention.

In addition to forms, there are also types of appendicitis. These are:

Simple appendicitis. It is expressed by mild symptoms, which greatly complicates its diagnosis. At the same time, it can only hurt upper part abdominal cavity.

Quite often, with this type of appendicitis, doctors observe the patient’s condition for a long time and are in no hurry to perform an operation. During this time, the patient undergoes blood tests and an X-ray examination.

Phlegmous appendicitis is accompanied by severe pain in the lower right abdomen. Also, the patient’s temperature often rises, the heartbeat quickens and the tongue becomes dry. When palpating the abdomen, a person will feel pain. The muscles of the abdominal walls themselves are very tense.

With the phlegmous form of inflammation, the vermiform appendix of the intestine may increase in size. Also, pus sometimes accumulates in it. This condition very dangerous, because in the absence of timely treatment, the appendix can burst in just a few hours, and then all the pus will penetrate into the abdominal cavity.

The perforated form at the initial course is somewhat similar to the simple one, however, fecal stones can form in the patient’s abdominal cavity due to holes in the appendage. In this condition, toxins appear in the patient’s blood, causing a severe deterioration in the person’s general condition.

Characteristic signs of a perforated form of intestinal inflammation will be low blood pressure, nausea, increased frequency of heart rate And strong tension belly.

The gangrenous form of intestinal inflammation is considered the most dangerous. In this condition, the cells of the appendix simply die, which leads to complete absence pain or their weakening. At the same time, the person becomes very weak and pale. His body temperature may rise, vomiting, and nausea may occur. On palpation, the abdomen is tense, and bloating may also be observed.

As shown medical practice, gangrenous form appendicitis develops within twelve hours after the initial inflammation and the manifestation of the main symptoms. Next, the appendix ruptures and its contents spill into the patient’s abdominal cavity. In the absence of timely treatment, death can occur.

It is worth mentioning separately about the so-called false appendicitis. Its manifestations may develop not due to inflammation, but due to parallel symptoms. Symptoms of this condition may include nausea, pain, and diarrhea.

Common appendicitis syndromes

The first signs of appendicitis largely depend on its shape, gender of the patient, as well as physiological state person (if inflammation occurred during pregnancy, for example).

There are four main syndromes that may indicate the development of appendicitis:

Pain syndrome. In this case, the pain can be very different and can also be localized in different areas abdominal cavity, however most often in.
Dyspeptic syndrome involves the appearance of disorders in the patient’s gastrointestinal tract.
The inflammatory syndrome is accompanied sharp increase body temperature.
Peritoneal syndrome is accompanied by shortness of breath, weakness and tension in the abdominal muscles of a person.

Important! Quite often general signs appendicitis is confused with normal food poisoning or an upset stomach. In this case, a person may not consult a doctor at all, believing that the disease will go away “on its own.” This is actually a huge mistake and can lead to a ruptured appendix. For this reason, it is better not to take risks and immediately consult a doctor when the first signs appear.

How to identify signs of appendicitis yourself

To make it easier to understand that this is appendicitis, when the first suspicions arise, you should do the following:

A person needs to lie down on a flat, hard surface and press on the stomach in the area of painful sensations. If even with slight pressure there is a clearly visible pain in the right side of the abdomen, then you need to urgently consult a doctor. This is a dangerous sign acute inflammation.
Under normal conditions, the abdomen should be soft when pressed. If the abdominal cavity is hard, then this may be a sign of intestinal inflammation.
You can also straighten up and walk around a little. If there is inflammation of the intestine, then it is impossible to do this without pain. Usually the pain subsides only when the person turns sideways and brings his legs to his chest.

Main symptoms

The following main signs of inflammation are distinguished:

Increased body temperature.
Chills.
Fever.
Increased sweating.
Constipation.
Nausea and vomiting, which is often repeated.
Diarrhea with blood particles.
Severe pain in the lumbar area, which is similar to colic in the kidneys.
False urge to go to the toilet.
Sharp pain in the abdomen. The localization of pain can be very different.
Dyspepsia.
Darkening of urine.
Decreased appetite.
Pallor.

Dangerous manifestations of appendicitis

Insidiousness of this disease is that sometimes it can manifest itself with completely different (uncharacteristic) symptoms. This will significantly complicate the diagnostic process.

Dangerous symptoms of appendicitis are those manifestations that distract from the main disease or indicate the development of peritonitis.

Moreover, in women such manifestations of the disease can be confused with inflammatory diseases of the gynecological part, and in children - with intestinal colic, which are often inherent in them.

The most dangerous signs of acute inflammation are:

Black feces are a very dangerous sign. It may indicate intestinal bleeding.
Pain that suddenly subsides after sudden onset of pain may indicate a rupture of the walls of the appendix.
Constant vomiting.
Softening of the abdomen after its hardness upon palpation may also indicate intestinal rupture.
Sudden temperature changes.
Disturbance in the patient's consciousness ( delirium, confusion, etc.) This may indicate severe intoxication of the body. In this condition, a person requires urgent medical attention.

Clinical diagnosis of appendicitis symptoms

Diagnosis of appendicitis should always take place in a hospital setting by conducting the following studies on the patient:

General blood and urine analysis.
Anamnesis collection.
Ultrasound of the abdominal cavity.

Besides, prerequisite When detecting appendicitis, it is necessary to inform the doctor about such a symptom as pain. The fact is that it is the painful syndrome that is the main symptom of this pathology, so it has a very important when differentiating appendicitis.

To avoid distortion of the patient’s clinical indications, it is prohibited to give him painkillers before a diagnosis is made.

When palpating the abdomen, the doctor may ask about the following manifestations of pain:

Localization of pain. It can be on the left, right and middle of the abdominal cavity. The pain can also radiate to the heart and kidneys.

If pain is observed in right area abdomen, this means that the appendix is located on close range from the walls of the peritoneum.

Change in pain. With inflammation of appendicitis, a person may experience pain when coughing, raising a leg, right arm, or simply supine position on the back.
Nature of pain. In this case, a person may be bothered by cramping, dull, aching, or stabbing pain. The worst thing is if, after acute pain, the patient’s this symptom(this may indicate the development of peritonitis).

Important! The manifestations of appendicitis also largely depend on its neglect. For example, if this is acute inflammation, then its signs will be pronounced. IN chronic form human illness will be bothered by more subdued signs.

Features of appendicitis in men

This disease usually appears in men between the ages of twenty and thirty. Teenagers also often get sick.

It was noted that intestinal rupture most often occurs in men. This may be due to advanced diagnosis of appendicitis.

Inflammation in men is characterized by pain in the groin when the examining doctor palpates the abdomen.

Inflammation of the intestine in women

Women usually suffer from appendicitis from about the age of twenty. When diagnosing this disease, it is very important to differentiate it from inflammation of the appendages and ectopic pregnancy.

Intestinal inflammation in children

Inflammation of the intestine in young children is always difficult to diagnose, since the child cannot really explain where and how it hurts. He may cry, be fussy, and not clearly indicate his symptoms.

Typically, acute inflammation in children is manifested by severe pain. It is not difficult to identify it - you just need to lift the child’s right leg and try to bend it at the knee. If pain occurs in the right side of the abdominal cavity, then this is a clear sign appendicitis.

Doctors can also use another diagnostic method– applying pressure to the abdominal cavity followed by a sharp removal of the hand. At the same time, it will also be felt pain syndrome, indicating inflammation of the intestine.

Additional signs of acute intestinal inflammation in children are:

Weakness and decreased mobility of the baby.
Pain that gets worse when walking and jumping.
Vomit.
In young children, it is possible to observe the right leg being pulled towards itself in a bent state.
Tongue taxation.
Increased heart rate.
Diarrhea.

Manifestations in older people

Appendicitis in older people occurs calmly, without pronounced symptoms. In this case, a person may only suffer from pain in the abdominal cavity. The temperature is slightly elevated or normal.

Important! The weak severity of appendicitis symptoms in older people does not mean that they easily tolerate the disease. On the contrary, patients in the older age group are more susceptible to complications and death.

Features of the course in pregnant women

Detecting appendicitis during pregnancy is very difficult task, at the same time, at any time during its course.

Usually in this condition the appendix moves slightly towards the liver. This makes it difficult to identify the source of inflammation.

Diagnosis of the disease, in addition to testing, involves identifying pain while lying on the right side and on the back.

A woman may also be prescribed an MRI and ultrasound of the abdominal cavity. If acute inflammation is detected, urgent surgical intervention. The period of gestation does not matter. The main task of such an operation, in addition to removing the inflamed intestine, will also be to preserve the pregnancy.

What not to do if you suspect appendicitis

Before visiting a doctor, you should know what not to do so as not to harm yourself:

You should not take painkillers, laxatives and antipyretics, as they will eliminate important symptoms diseases.
You should not take any bowel medications as they may cause chemical reaction and further rupture of the appendix.
You cannot eat or drink anything, as urgent surgery may be required after diagnosis.
Do not apply ice or a warm compress to the sore spot.
Can't study physical activity. It is best to call an ambulance to take the person to the hospital.

Prevention of appendicitis

To reduce the risk of developing appendicitis, it is important to follow these recommendations:

Eat right.
Stop drinking alcohol.
Eat more fermented milk products and fruits.
Don't overeat.
Treat gastrointestinal diseases in a timely manner.
Do fasting days.
Avoid constipation.

Anton palaznikov

Gastroenterologist, therapist

Work experience more than 7 years.

Professional skills: diagnosis and treatment of diseases of the gastrointestinal tract and biliary system.

Appendicitis, or inflammation of the appendix of the cecum (appendix), is a common pathology that can only be treated with surgery.

The appendix is an internal organ that is usually located in the lower right abdomen.

The risk group includes both adults and children, starting from 3 years of age. Symptoms of appendicitis vary depending on the stage of the disease and the age of the patient (young women are more likely to get sick than men and older people).

Appendicitis is especially dangerous for pregnant women and the elderly.

The first sign of appendicitis in men, women and children is abdominal pain

The main and main symptom of appendicitis with the classic location – constant stabbing (sometimes aching) pain which begins suddenly, without brightness expressed reason, usually in the afternoon.

Initially, characteristic pain is felt in the navel area and above (this is the epigastric zone), then a change in the nature of the pain is observed, they become more pronounced, intense and are localized on the right side in the iliac region (in the lower abdomen on the right).

A person in this condition cannot walk easily. As with walking, when coughing and laughing, a person experiences attacks of severe acute pain. The only thing the patient can do is lie in a certain position on the right side or on the back, otherwise the pain will increase significantly.

If the location of the appendix is atypical(retrocecal appendicitis occurs in 5%-12% of cases, and pelvic appendicitis in 8-19%), then pain from the epigastrium (as the periumbilical region is called) is shifted not to the lower right abdomen, but to groin area, in the lower back or hypochondrium, depending on the location of the appendix. Although at first, as with ordinary appendicitis, constant, stabbing pain suddenly occurs, in these cases there is often a slow increase in symptoms, they are weakly expressed, which is why the clinical picture of the disease is not bright.

With a pelvic location of the appendix(the cecum is located in the pelvic area and is often close to bladder and to the rectum) it may hurt in the area above the pubis. The pain is unpleasant and similar to that observed with inflammation of the genitourinary system.

Important! If the pain suddenly subsides and disappears, this may indicate the beginning of the necrosis process nerve cells process walls. This is a sure sign that there will be peritonitis (which is accompanied by very severe pain, weakness, fever and even loss of consciousness), which leads to complications and even death. Therefore, if you suspect appendicitis, you should urgently call an ambulance.

Stages of development or types of appendicitis

The general period for the development of appendicitis is 48 hours or two days. After this, inflammation leads to serious complications, which is life-threatening.

The classification of forms of acute appendicitis according to the degree of its development is as follows:

Classic appendicitis begins with the emergence favorable conditions for the development of pathogenic microflora, resulting in an inflammatory process on the mucous layer of the inner walls of the appendix. This is the catarrhal stage, in which the symptoms are hidden. It turns into a superficial form, when the focus of inflammation is already visible. Initial stage lasts during the first 12 hours of the attack.
Second phlegmonous stage– this is when developing destructive changes begin to appear, leading to inflammatory processes in all tissues of the walls of the appendix. After this, the peritoneum becomes inflamed and its irritation causes the main symptoms or manifestations of the disease. The first sign is characteristic pain in the right iliac region. It happens that the formation of several foci of inflammation occurs, then they speak of phlegmonous ulcerative appendicitis. This stage lasts about 36 hours and begins on the second day after the onset of the disease. During this time, removal of appendicitis does not lead to severe consequences and proceeds easily for humans.
Gangrenous form, this is an advanced destructive stage lesions, when due to necrosis (death) of the tissues of the appendix, a loss of sensitivity occurs and the person’s constant pain disappears. The next perforation stage - perforation (rupture) or perforation of the walls leads to purulent peritonitis(pus comes out of the appendix and enters the abdominal cavity). This is accompanied by the fact that it suddenly appears sharp pain, and if surgery is not performed urgently, death occurs.

Chronic appendicitis occurs in 1% of cases, more often in young women. In this disease, inflammation of the appendix is gradual and slowly developing. Main symptom- increased pain in the right iliac region during physical activity, during tension of the abdominal muscles during bowel movements or during coughing.

It happens that the symptoms chronic appendicitis bother a person for several years. The disease may progress to acute form throughout this entire period. In this case, use conservative treatment, this way they relieve inflammation, swelling and restore the blood circulation process (taking antibiotics, diet and nutrition according to the clock)

During periodic exacerbations, nausea and vomiting appear, as well as stool disorders (constipation or diarrhea) and other symptoms of acute appendicitis. For treatment, surgery is performed to remove the appendix (appendectomy).

The most common causes of appendicitis and its prevention

Possible causes of appendicitis:

Prevention of appendicitis:

Changes in the clinical picture in adults hourly

Symptom	Stage I Catarrhal (first 12 hours)	Stage II Phlegmonous (from 12 – 48 hours)	III Stage Gangrenous (after 48 hours)
Appetite and general condition body	Most early sign, loss of appetite and general discomfort. Bad dream.	No appetite. A person can only lie on his right side, or lie on his back.	A body condition similar to severe intoxication for food poisoning
Pain	Initially, the pain is mild in the epigastric region (near the navel). If the pain is very severe from the very beginning, this indicates a serious circulatory problem in the appendix due to thrombosis of the appendicular artery.	Intensification and localization of pain in the right lower abdomen.	Very strong. Then, due to the death of nerve cells, the pain subsides. If appendicitis bursts or perforation of the appendix occurs and its contents are released into the abdominal cavity (the infection spreads to the abdominal cavity), this is manifested by sharp pain.
Weakness	Minor	Stronger	It's impossible to do anything. Severe weakness may lead to loss of consciousness. This is a very dangerous condition.
Body temperature	Normal or low-grade fever(37.3˚С – 37.5˚С)	Increase to 38˚С (according to Widmer's symptom, temperature in the right armpit slightly higher than on the left). During inflammatory processes, the temperature in the rectum is approximately 10 degrees higher than in the armpit	High (from 38˚С – 40˚С). May lead to hyperthermia or fever
Language	There is no dry mouth; there is a specific white coating at the base.	Not dry, all white	The tongue is dry and all white
Nausea and vomiting	6 hours after the onset of the attack, nausea appears, gag reflex weak.	Vomiting once or twice indicates the development of destructive changes. It does not provide relief and, in fact, is the body’s reflex response to pain.
Dry mouth	No	Begins	Strong
Chair	Defecation disorders (constipation, sometimes diarrhea, diarrhea, flatulence, bloating, loose stools) With a pelvic location of the appendix - frequent loose stools with mucus and blood
Urination	An increased urge to urinate (dysuria) if appendicitis is located near the bladder
Pulse	Violated if present concomitant diseases	80-85 beats/min.	Rapid (tachycardia)
Pressure	Blood pressure increases if there are concomitant diseases that are aggravated by appendicitis. For example, shortness of breath occurs (difficulty breathing)		Increased

Symptoms of appendicitis in children

Total time The development of the disease in children is much shorter than in adults and lasts 24–36 hours. The table below provides information on the manifestations of the disease at three main ages when appendicitis is likely to occur. Appendicitis practically does not occur in one-year-old children, and in adolescents (from 11 to 18 years old) the symptoms are similar to those of the disease in adults.

Symptom	In children under 3 years of age	In children from 3 to 6 years old	In children from 7 to 10 years old
Feature of age	Can't tell where it hurts.	Can tell where it hurts, but may not pay attention to it mild pain and don't tell your parents.	A child may be afraid to tell their parents about stomach pain because they are scared.
Loss of appetite	Refusal to eat is identified as the earliest sign of appendicitis in children
General condition of the body (weakness)	The child is lethargic, something is constantly bothering him ( bad dream), sharp monotonous crying.	Weakness. Unreasonable irritation and crying.	Weakness.
Pain	My stomach hurts. The pain intensifies when bending to the right. The child cannot lie on his left side. Painful sensations when walking. When you press, the pain subsides, but if you release your hand, it intensifies.	The stomach hurts, the nature of the pain, the child is not able to say	At first the whole abdomen hurts, then after 2-3 hours in the classic case it spreads to the lower right half. The pain intensifies when bending down.
Body temperature	Up to 40˚С	38˚С – 39˚С	Up to 38 ˚С (chills)
Language	At stage 1: no dryness with a white coating at its base At stage 2: no dryness, all with a white coating At stage 3: dry, the entire tongue is coated
Nausea and vomiting	Nausea and repeated vomiting occur		Vomiting 1 – 2 times
Dry mouth	Present on last stage illness (child wants to drink)
Chair	Liquid (sometimes with mucus), causing dehydration.	Bloating (flatulence or increased gas production), stool retention, but not constipation	Constipation is rarely present
Urination	Painful	Normal	Normal in a typical case (or frequent, with a pelvic location)
Pulse	Above normal		“Symptom of toxic scissors” Pulse does not correspond to body temperature. It is usually higher than normal. Normally, the pulse should increase by 10 beats/min. with a temperature increase of 1˚C
Child behavior	little child does not allow himself to be examined and pulls his right leg towards him.	Restless	Weakness

Important! If a child has a stomach ache for 6 hours, has a fever and other signs of appendicitis, it is necessary to immediately consult a doctor.

Diagnosis of appendicitis - symptoms by authors

Diagnostic measures begin with the doctor receiving data about the patient’s complaints and conducting an examination. What methods are used to make a diagnosis of appendicitis? Below are the symptoms by author and a little information about how they are tested.

Author clinical symptom	How to check	When the symptom is positive (appendicitis is diagnosed)
Shchetkin Bloomberg	The doctor presses right hand on the right iliac region, then abruptly releases the hand.	Man feels severe pain when the doctor releases his hand.
Kocher (pain migration symptom)	Most important symptom. The pain begins in the epigastric region (near the navel) and moves to the right lower half of the abdomen
Voskresensky (shirt symptom)	The surgeon pulls the patient's shirt down with his left hand. The patient takes a deep breath, and the doctor at this moment makes a sliding movement with his fingers from epigastric region to the right side.	When stopping the movement of the arm at the very end, without lifting it from the abdominal wall, a sharp pain appears
Barthomier–Mikhelson	The patient lies on his left side. The doctor presses on the place where the appendicitis is located.	Pain increases during palpation
Rovzinga (Rovsinga)	The surgeon presses his fingers on the left iliac region of the abdomen, and at the same time pushes along the rectum with his right hand. The movement of gases in the colon causes irritation of the appendix.	Pain appears in the right iliac region (irritation of the inflamed appendix causes pain).
Razdolsky (Mendel)	The patient lies on his back. The person conducting the inspection performs a light tap with his fingers on the front abdominal wall in the right iliac region.	Pain appears.
Sitkovsky	The person lies down on his left side.	Pain appears or intensifies in the right iliac region.
Ivanova	The distance from the navel to the most protruding part of the pelvis on the left and right is compared.	Right is smaller than left
Ostrovsky	In the supine position, the patient’s straight right leg is raised at an angle of 130˚C and held in this position, and then sharply released.	Pain in the right iliac region.
Aaron	The doctor presses on the right iliac fossa	There is a feeling of fullness in the epigastric region
Volkovich	The patient bends over left side	Pain intensifies in the area of the appendix
Krymova	The doctor palpates the external opening of the inguinal canal	Pain appears in right half lower abdomen
Obraztsova	Used to diagnose acute retrocecal appendicitis. The patient, lying on his back, raises his straight right leg.	Painful sensations appear
Cope	Used to diagnose pelvic appendicitis. There are two ways to check for this symptom: The patient lies on his left side. The doctor moves the right leg straight back (this way the person can stretch the iliacus muscle). The patient lies on his back. The right leg is bent at the knee; if pain occurs, the symptom is considered positive.	Pain appears at the location of appendicitis
Gabay	Similar to Shchetkin Blumberg’s symptom (first press and then sharply release the hand) only palpation is carried out in the lower back area of the Petite triangle	A characteristic pain appears on the right side
Yaure Rozanova	Used only for atypical (retrocecal) location of the appendix. The doctor presses his finger into the so-called "Petit"	Soreness appears

In men, appendicitis is also manifested by slight tightening of the testicle with right side during examination by palpation. Gently tugging on the scrotum also causes pain in the right testicle.

In women, diagnosis becomes much more difficult if the attack began during menstruation.

Important! To make a diagnosis it is necessary to see the complete clinical picture. Therefore, if appendicitis is suspected, the patient needs to see a doctor and urgent hospitalization for more thorough examination. This cannot be done at home.

In the hospital, to determine the disease, it is necessary to take general analysis blood and urine. Rarely does a surgeon prescribe a rectal examination (only in cases of low pelvic position) or quite often a vaginal examination (in women this excludes the presence of gynecological and urological problems). If the picture is unclear, additional consultation with a gastroenterologist and gynecologist is often necessary.

If general blood test shows increased amount leukocytes in the blood (above the norm 9 in the absence of pregnancy in women), this indicates the presence inflammatory process. If it turns out that this indicator exceeds 20, there is a possibility of ruptured appendicitis (peritonitis). Leukocytosis is observed in 52% of cases. Otherwise medical specialists they say that it may be latent appendicitis (the history or symptoms of this disease are somewhat different). The amount of C-reactive proteins in the blood also indicates the presence of inflammation (the norm in adult men and women is 10 mg/l; levels above the norm may indicate an inflammatory process, with the exception of pregnant women, for whom the norm is 20 mg/l). Reactivity indicators increase 12 hours after the onset of the attack.

General urine test in 25% of cases (with pelvic and retrocecal appendicitis), it shows the presence of a small number of retrocytes and leukocytes.

If this is not enough and it is not possible to accurately diagnose appendicitis, except for tests and examination of the patient by a surgeon, for further diagnostics and its detection is carried out row instrumental studies . More often, ultrasound of the pelvic organs and laparoscopy. Unlike ultrasound examination, the laparoscopic method allows you to accurately determine the presence or absence of pathology, and if the diagnosis is confirmed, the appendicitis is immediately removed. Laparoscopy is most often performed under general anesthesia, therefore it has a number of contraindications.

What are the dangers of appendicitis and its complications?

Appendicitis is dangerous due to its complications, or rather their consequences. Many of them pose a threat to human life and health. Therefore, the most important thing in successful treatment pathology and reducing the risk of death has a timely visit to a doctor and early diagnosis.

The most common complications of appendicitis are:

Quantity indicators deaths(cases of death) from appendicitis are increasing significantly, in critical cases, patients are admitted to the hospital requiring emergency care, With advanced disease on late stages with complex peritonitis or pylephlebitis.

Important! If you suspect appendicitis, be sure to immediately contact an ambulance, regardless of your location! This measure can save lives! Before a medical examination, you should not use a heating pad, give painkillers or laxatives.

Treatment of appendicitis - emergency appendectomy

Treatment for appendicitis is emergency surgery to remove it or appendectomy. Surgery is performed either through one large incision (7-10 cm) or through three small incisions (1 - 2 cm). laparoscopic method under general anesthesia.

In order to determine the location of the incision, they are guided by the Mac Burney point.

The earlier the disease is diagnosed, the easier the operation is for the patient.

There are often cases when the surgeon already during the operation becomes clear that there is no appendicitis, then intraoperative differential diagnosis. During laparoscopy, special attention is paid to gynecological pathologies.

An incident from life. One patient underwent laparoscopy. During the examination, it was discovered that appendicitis was combined with ovarian rupture.

In most cases the prognosis is positive, the difficulty arises when:

old age
presence of a large number of associated chronic diseases (serious illnesses heart, kidneys, liver and others internal organs)
advanced stage of the disease.

Complications after appendectomy may include:

Internal bleeding
Postoperative inguinal hernia(depends on the patient)
Formation of infiltrates
Internal abscesses
Supuration of sutures due to infection
Adhesive processes in the intestines leading to the formation of fistulas (after removal of appendicitis with diffuse peritonitis)
Intestinal obstruction (a person suffers from sharp pain and from other dangerous consequences)

Postoperative period

Immediately after appendectomy for approximately 12 hours you need to lie down, but you cannot eat or drink. If necessary, a special drainage tube is installed at the incision site, which is necessary to drain internal fluid and administer antibiotics. It is removed already on the third or fourth day. The doctor will prescribe painkillers for some time after the operation.

In the second half of the first day you won't be able to drink large number acidified water.

On day 2, you can eat a little low-fat kefir or cottage cheese. It is already necessary to try to get out of bed and slowly walk. In active patients, the body's recovery proceeds faster.

The sutures are removed 7–10 days after surgery.

You need to stick to a diet for about a week and a half, and then you can gradually introduce your usual diet.

During recovery, you should wear a compression bandage and reduce any physical activity(under no circumstances should you lift heavy objects).

Important! The postoperative period after appendectomy for simple appendicitis lasts from 20 days to a month. If the operation was performed on an elderly person or appendicitis with peritonitis was removed, then for full recovery body, it may take up to six months.

+ + Perforated ulcer
duodenum + + + Pancreatitis + + + + Meckel's diverticulitis + + + + Adnexit
(inflammation of the uterine appendages) + + + Apoplexy
(ovarian rupture) + + + + Colitis + + + Intestinal tuberculosis + + + + Cystitis + + + Kidney inflammation + + + Cholecystitis + + + +

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

Step One: What Symptoms 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

And so, if your temperature is 38 or higher, then clearly what you should not do is wait, you should call a doctor.
It is strictly forbidden to take laxatives and painkillers.
Don't accept antacids. They can also aggravate the pain associated with appendicitis.
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

When will he arrive ambulance, 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.
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.
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 the development of peritonitis.

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

People with the following conditions may not have the classic symptoms of appendicitis. Although symptoms such as fever, abdominal pain, and bloating are common, such people may only feel a general state of 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:

The development of the inflammatory process in the appendix is 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!

“... appendicitis is not found where people think about it,

and are discovered where they don’t even suspect its existence...”

I. I. Grekov (Russian surgeon, diagnostician)

What is appendicitis?

Appendicitis is strong process inflammation in the appendix, the appendix, which is located at the mouth colon. This is shown more clearly in the figure:

Exacerbation can occur at any age. And yet there are risk groups:

V age groups 2-3 years, 7-9 years and from 12 to 15 years;
adults under 30 years of age;
women expecting a child.

Risk factors that increase the likelihood of developing the disease:

deterioration of intestinal motility;
weak intestinal tone;
hit foreign bodies to the appendix;
frequent vascular spasms (nervous tension).

Causes of appendicitis

Oddly enough, one of the most common surgical diseases still has no clear causes for its occurrence.

There are only versions, hypotheses that explain the causes of the disease, here are a few of them:

Sometimes while taking any medicines, appendicitis can begin asymptomatically.

The first symptoms of appendicitis in adults

In order to understand and react in time to the problem that has arisen, you need to know the symptoms of this intestinal inflammation. Most often, the first manifestation of the disease is pain, which is localized around the navel and has an aching, “spread” character, when it is impossible to determine exactly where it hurts.

About an hour and a half after its first manifestation, gastrointestinal disorders may appear.
Within 4 hours, constant pain will shift to the iliac region on the right, and will intensify with coughing and changes in body position. May appear high temperature and chills.
Within half a day after the first sensation of pain, the pain will become more intense and less bearable.

Remember that any sharp pain in the abdominal area that does not disappear within 6 hours is a clear sign surgical disease and require immediate medical examination!

The surgeon tells more about the symptoms of appendicitis:

The first symptoms of appendicitis in children

In children, the disease develops faster than in adults.

Sad statistics indicate that 50% of children admitted to the hospital already have complications in the form of a ruptured appendix and peritonitis.

The beginning of many diseases gastrointestinal tract and pelvic organs are similar to the signs of appendicitis. In females, this location of pain can accompany many genitourinary diseases; in children - intestinal infections, colic. Therefore, the final diagnosis should only be made by a doctor. Danger signs appendicitis itself is a sign that the disease is entering an advanced stage:

subsided pain or its complete absence - may indicate a rupture of the walls of the appendix;
vomiting that is constant;
an increase in body temperature to 39 degrees, maybe more, or a sharp drop below 36 degrees;
high tone of the abdominal muscles, pain when touched;
inadequate state – reduced and delayed reactions, confusion, delirium.

Nature of pain in acute appendicitis

Despite the large number of signs, it is by analyzing pain that the doctor will make a diagnosis, and therefore the pain cannot be dulled by taking painkillers before examining the patient by a doctor.

For a correct diagnosis, the doctor will analyze pain in combination with other signs: body temperature, gastrointestinal and other manifestations of the inflammatory process. As a rule, when analyzing pain sensations, the doctor determines the presence of appendicitis in the following ways:

The examinee, as a rule, is not able to show where the source of pain is located, but within 4 hours the pain sensations shift to the right iliac region.
With uncomplicated appendicitis, the pain will be stronger when the patient, lying on his back, tries to suck in his stomach, or when he turns over to his left side (the pain will shift to the navel).
Pain during defecation in the anus.
Pain when sneezing or standing up right leg or hands.

The pain may be radiating. With this intestinal inflammation, they can be observed as:

the appearance of right-sided lameness;
pain in the scrotum (in males).

Pain during intestinal inflammation can be constant or cramping in nature.

Diagnosing appendicitis

Please note that you can diagnose this disease yourself - press firmly with your fingers on the right lower abdomen and release sharply. With appendicitis, when you press, there will be no pain, but acute pain will occur when you sharply remove your fingers.
Diagnose it intestinal inflammation in typical cases it is not difficult; atypical features of the development of the inflammatory process can complicate diagnosis. In order for the diagnosis to be made correctly, doctors use special diagnostic techniques and check the presence/absence the following signs, in which increased pain will speak in favor of appendicitis:

Rovsing's symptom - the doctor presses with his fingers in a jerky manner in the left lower abdomen.
Sitkovsky's symptom - the person being examined simply lies down on the left side of the body.
Bartomier-Michelson's symptom - the doctor performs palpation when the person being examined lies on his left side.
Obraztsov's symptom - lying on your back, you need to raise your straightened right leg.

Differences between appendicitis in women and men

Signs of appendicitis in females , which may not appear in men, and are confirmation of the disease only in the presence of other signs of the disease:

when impacting the rectum, especially lying on the left side, pain occurs;
when the fingertips make a forward movement across the abdomen, towards the right iliac region, acute pain appears in the internal organs;
if you gently tap on the lower abdomen, a dull sound is heard on the right;
if you influence the area just below the navel of a lying woman and then ask her to sit up, there will be an increase in pain (Zhendrikinsky's symptom).

Difficulties in diagnosing this disease in females lie in the similarity of symptoms various diseases. So, pain in the intestines is similar to menstrual pain. And if a woman is pregnant, gastrointestinal disorders may not be given much importance at all. It is important to know that the signs of appendicitis in women expecting a child are subtle.

The growth of the fetus and the increase in the size of the uterus can cause displacement of internal organs, which can also affect the location of pain.
For pregnant women, there are several diagnostic methods, after which An increase in pain indicates appendicitis:

rolling the diagnosed patient from side to side when she lies on her back;
changing any body position to the “lying on the right side” position.

Signs of appendicitis in men are general.

Rehabilitation after appendicitis removal

The general course of rehabilitation can last up to 60 days and depends on individual characteristics.

After surgery, the patient is transported to a ward where he will be monitored medical staff. If there are no complications, 8 hours after transfer to the ward, the person being operated on can already carefully move and rise. Walking is allowed after 3 days. Must be worn postoperative bandage. The patient is prescribed medications to reduce pain and antibiotics to avoid complications. The duration of hospital stay in the absence of complications is about ten days. Important place in postoperative period takes a strict diet, which is recommended by the attending physician for the entire period of rehabilitation.

For more information about nutrition after surgery, watch this video: