Appendicitis – symptoms, treatment and picture
Before the advance of the surgery the appendicitis was a fatal disease. All suffering from appendicitis were dying from its complications. Today this is the most common acute abdominal disease. The earliest changes are expressed in the presence of defects in the mucosa, around which are found single inflammatory cells – an initial (early) appendicitis. For about one day the purulent inflammation includes the entire wall of the appendix and a flegmonous appendicitis is developing. A gangrenous appendicitis develops when the inflamed wall of the appendix dies.
Symptoms of appendicitis
- Feeling of pressure in the area of navel or upper part of abdomen, associated with nausea and vomiting. Soon the pain moves to the lower abdomen, right below the navel. When pressing and sudden relaxation of the hand in this area, the pain intensifies. At the same location the abdominal wall is stretched.
- In breathing the patient spare his abdomen. At very removable caecum the appendix can be located low down in the pelvis or high above to the stomach. In this case the pain on pressure can be missing or to be located in an atypical place. The tension of the abdominal wall can also be missing, which is very typical in older people.
- Crying small children explore on abdomen. The thumbs are placed on the seat and the other fingers examinate the tummy during pauses of breathing.
- The cowardly children almost always are ready to stand up and jump when someone catch them for hands. If they have acute appendicitis, children can not be make to jump.
- The temperature is high and shows difference with 1 degree or more in a comparatively measuring axillary and rectal.
Complications of appendicitis
Perforation (rupture) of the appendix - leads to peritonitis. Covered perforation develops when there are adhesions around the appendix, which prevents the dissemination of the suppurative process. In that way appears the periapendicular abscess (cavity filled with pus) around the appendix. If this abscess picks out and pus leaks out through the abdominal wall, it can lead to spontaneous cure. In place of the breach is formed fistula (channel), that continuously secrets malodorous purulent matter. In the past, before the development of surgery, that was almost the only chance for rescuing the patient with acute appendicitis. Self- amputation of the appendix may result in destruction of the wall by heavy inflammation. Then appendix is detached from its base and drops out into the abdominal cavity. This also leads to severe peritonitis. Empyema of the appendix develops in obstruction of the lumen, in which the wall is inflating and his cavity fills with pus.
If pus is resorbed, the appendix remains as a pouch, filled with mucus material. This condition is called mucocele.
Treatment of appendicitis
The treatment is surgical. It consists of removal of the appendix. Patients with suspection for appendicitis must be admitted to a hospital immediately! In suspect cases it is better mistake sending to a hospital than waiting perforation at home. Absolutely is contraindicated acceptance of analgetic medicines before specification of diagnosis, because this may obscure the symptoms of appendicitis and to mislead the clinician. Putting warm heating pads and compresses on the abdomen is also forbidden.