home Consultations Appendicitis: can surgery be avoided? How long can appendicitis hurt, and what to do in such cases?

Appendicitis: can surgery be avoided? How long can appendicitis hurt, and what to do in such cases?

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

The most serious complication of appendicitis is the rupture of the appendix and the release of contents into a sterile abdominal cavity, as a result, peritonitis develops.

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 state 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;
Old people;

Causes of appendicitis

The reasons for it have not been sufficiently studied.

The disease refers to inflammatory processes:

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

Quite often the appendix becomes inflamed after gastrointestinal overload big amount 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 enough vegetables and fruits in your diet. 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 last 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!

Our readers’ questions about this “master of transformation” are answered by the Deputy Chief Physician for Surgery of Moscow City Clinical Hospital No. 31, Ph.D. medical sciences, surgeon of the highest category Avtandil Manvelidze.

No organ - no problem?

– I heard that somewhere in the middle of the last century in America it was customary to get rid of the appendix of every newborn baby. Why did doctors abandon this idea, because, as they say, if there is no organ, there are no problems? Olga, Saratov

– Indeed, in the last century in America, prophylactic appendectomy was widely practiced. But then we had to abandon this, because as a result of many years of observation of these people, it turned out that removing appendicitis in infancy led to the development of serious immune disorders from the intestines.

How to the “extra” organ to the appendix for a long time also applied in Russia. In fact, there are no extra parts in the body. The appendix does not take part in the digestive process, but since it consists of lymphoid tissue in which cells that perform immune functions function, it plays important role in protecting the gastrointestinal tract from infections. For this reason, this appendage is sometimes called the “intestinal tonsil.”

Painkillers are prohibited

– What should a person do if he is “caught” by an attack of acute appendicitis? Ekaterina, Moscow

– You only need to do one thing - dial the ambulance number on the phone, without waiting for peritonitis to develop. But what you should never do is take painkillers, because taking them will “lubricate” clinical picture disease and it will be more difficult for the doctor to make a diagnosis. IN as a last resort If the pain is unbearable, you can drink no-shpa, but it is still better to wait until the doctor arrives and refrain from using any medications. Another common mistake is to apply a warm heating pad or bath to the sore area. This is the shortest way to increase inflammation and accelerate development purulent peritonitis. Do enemas, drink choleretic drugs It's also not worth it under any circumstances. All that is required is to provide the patient with complete rest.

No amateur performances!

– How can a person himself understand when there is pain in the right side – is it appendicitis or something else? Tatyana, Nizhny Novgorod

- No way. This is not his business, but the doctor’s responsibility. Even experienced specialist There are often doubts that he is dealing with this particular disease, because appendicitis very skillfully disguises itself as almost any ailment in the abdominal area. But since this disease is very dangerous dangerous consequences for a person’s health and even life, then in case of abdominal pain (and anywhere, not necessarily on the right), you should definitely call an ambulance, and not try to recognize the disease yourself.

The less time passes from the development of inflammation, the simpler and shorter the operation will be. rehabilitation period. Unfortunately, the biggest problem is when people sit at home for a day, two, three, endure pain, and then are admitted to the hospital with peritonitis, when pus has spread throughout the entire abdominal cavity. And then they have to undergo an extensive, difficult, lengthy operation, after which they will be forced to spend in a hospital bed instead of a week whole month, if not more.

Examination according to the rules

– What tests are needed to make a diagnosis of appendicitis? Valery, Izhevsk

– First of all, the doctor interviews the patient and collects anamnesis. Asks leading questions, finding out when and under what circumstances the pain appeared, where it goes, etc. Then follows an examination and palpation. Then tests are taken (blood, urine) - high level leukocytes will confirm the presence of inflammation. It is also necessary to do an ultrasound of the abdominal cavity. And in some cases it is necessary to resort to diagnostic laparoscopy. Through a puncture in abdominal wall a device with fiber optics is inserted, and with its help, on the monitor, the surgeon can see a picture of what is happening inside the patient.

Seeds - nothing to do with it

“They told me since childhood: don’t eat seeds, don’t swallow watermelon seeds, otherwise you’ll get appendicitis.” And how they looked into the water - indeed, at the age of 20 I was operated on for this reason. Now my son is growing up, and I also forbid him to pollute his body with seeds. Am I doing the right thing? Nikolay, Orel

– The reasons for the development of inflammation of the appendix – the vermiform appendix of the cecum – are not known to science for certain. There are a lot of assumptions and theories on this matter, but none of them have been proven yet. As for seeds, I think their danger is exaggerated. A tomato or cucumber also has seeds, albeit small ones, and no one says that eating these vegetables is dangerous. Unfortunately, there is no way to prevent appendicitis. Well, except that we need to try to eliminate all inflammatory processes in the body in a timely manner, be it caries or sore throat, because chronic infection, wherever it is located, can provoke inflammation in other organs. However, this applies not only to the appendix, but to the entire body as a whole.

Not an easy simple operation

– Surgery for appendicitis is considered to be something elementary. Is this really so and can there be complications after this intervention? Alexander, Moscow

– Indeed, most often the first operation that is entrusted to a novice surgeon is an appendectomy. After all, this is the most common surgical intervention, because appendicitis is one of the most common “sores.” However, surgeons say this: “There is nothing easier than an operation to remove the appendix, and there is nothing more difficult than this operation.” After all, the cunning of this small appendage is inexhaustible. The appendix can be located in such “nooks and crannies” of the abdominal cavity that it will take a surgeon seven sweats before he gets to it. Therefore, the operation can last either half an hour or 2-3 hours. In mild cases, even a recent student can remove the appendix, but in complex cases, the hand of an experienced master is required. The decision about who to entrust the operation to is made during the intervention itself.

As for complications, they happen after any operation. Including after this one. They can range from problems with healing to an abscess in the abdominal cavity and even fatal. Mortality from appendicitis is 0.1 - 0.2%. These numbers could be even lower if people sought medical help on time and did not self-medicate.

No cuts

– Is it possible to perform surgery to remove the appendix without incisions? Ilya, Perm

– Yes, today laparoscopy is very often used for this disease. Then, after the intervention, only three almost imperceptible puncture marks remain on the patient’s body from the punctures through which the instruments were inserted. The advantages of using laparoscopy: reduced pain after surgery and faster recovery, as well as a good cosmetic effect.

But, unfortunately, laparoscopy is not always applicable, but only if it is technically possible. This can only be resolved during surgery. If the surgeon understands that laparoscopy is not suitable in this case, he resorts to the traditional method.

By the way

Appendicitis occurs in both children and the elderly, but more often this trouble occurs in the prime age - from 20 to 40 years. The number of patients among people of both sexes is approximately the same. Wherein hereditary factor may be important, but not decisive.

Appendicitis is a painful inflammation of the appendix, the vermiform appendage of the cecum that is located in the lower right side of the abdomen.

Appendicitis - common surgical disease. 4-5 people out of 1000 encounter it. Appendicitis most often develops at the age of 20-40 years, women get sick twice as often as men. There are no reliable measures to prevent appendicitis, but it is believed that eating plenty of fiber reduces the likelihood of developing the disease.

First there is pain in the middle of the abdomen. Then it goes to the bottom right side abdomen and gradually intensifies. Appendicitis requires emergency medical care, most often carried out surgery to remove the appendix. If appendicitis is left untreated, the appendix can rupture and cause potentially life-threatening complications.

It is not entirely clear what the causes of appendicitis are, but it is believed that the disease often develops when the entrance to the appendix is blocked, for example, by a small piece of feces.

What is the appendix?

The appendix is a small, rather thin, appendage 5-10 cm long. It is connected to the cecum, in which the feces.

The functions of the appendix are not fully understood. It is known that in the lumen of the appendix they actively reproduce beneficial microbes intestines involved in the digestion of food. In addition, the appendix is an intestinal “tonsil”, as it contains lymphoid tissue and participates in the formation of immunity and protection against infections. However, removal of the appendix has virtually no effect on human health, since the body is able to compensate for its absence.

Symptoms of appendicitis

Appendicitis usually begins with pain in the middle of the abdomen, which may subside and return.

Within a few hours, the pain moves to the lower right side of the abdomen, where the appendix is located, and becomes sharp and constant. The pain may worsen when pressing on the abdomen near the appendix, coughing, or walking.

If you have appendicitis, you may also experience other symptoms, such as:

If you experience abdominal pain that gradually gets worse, consult a doctor or call an ambulance immediately.

Appendicitis can easily be confused with another disease such as a urinary tract infection, Crohn's disease, gastritis, intestinal infection, or ovarian disease. However, all conditions in which a constant appears intense pain in the abdomen, require immediate medical attention.

Call the ambulance number - 03 from landline phone, 112 or 911 - from a mobile phone, if the abdominal pain intensifies sharply and covers the entire abdominal cavity. This possible sign appendix rupture.

When the appendix ruptures, bacteria enter the abdominal cavity, which can cause severe complications such as inflammation inner shell abdominal cavity (peritonitis) and blood poisoning.

Causes of appendicitis

It is not entirely clear what causes appendicitis. The appendix is connected to the cecum, in which feces are formed. It is located in the lower right side of the abdomen. It is believed that in some cases, appendicitis is caused by a small piece of stool that lodges in the appendix and blocks the opening. After this, bacteria in the appendix begin to multiply, it fills with pus and swells.

Some types of appendix blockage can also cause inflammatory diseases intestines, such as Crohn's disease and ulcerative colitis. The source of inflammation in the appendix can be a gastric infection that has moved through the intestines to the appendix. If a swollen appendix is not removed surgically, over time it will rupture and the infection can spread to other organs.

Diagnosis of appendicitis

Diagnosing appendicitis can be difficult, especially if you don't have typical symptoms. This happens in approximately every second patient. Moreover, sometimes the appendix may be located in an unusual place, such as in the pelvis, behind the colon or liver. The pain of appendicitis can mimic other diseases, such as a bladder or urinary tract infection, Crohn's disease, or gastritis.

The doctor will ask you about your complaints, examine your abdomen and check whether the pain increases with pressure in the appendix area (lower Right side abdomen). If your symptoms match typical signs appendicitis, this is usually enough for your doctor to make a diagnosis with confidence.

Additional examinations for appendicitis

If your symptoms are atypical, you may need additional examinations and tests to confirm the diagnosis and exclude other diseases. Investigations for suspected appendicitis:

a blood test to check if your body is fighting infection;
urine test to rule out other conditions, such as infection Bladder;
magnetic resonance imaging (MRI) or ultrasonography(ultrasound) - they have proven themselves very well in diagnosing appendicitis;
pregnancy test for women.

If your doctor thinks your appendix has ruptured, you will be sent to hospital immediately for treatment.

Treatment of appendicitis

If you have appendicitis, you will need to have your appendix surgically removed. Removing the appendix (doctors call this procedure an appendectomy) is one of the most common and safest surgeries.

Put accurate diagnosis It's not always easy. In some cases, it is necessary to resort to a complex examination, including surgical intervention to confirm or deny the presence of appendicitis.

Laparoscopic appendectomy

Typically, a minimally invasive surgery (medically called laparoscopy) is performed. Laparoscopy can shorten recovery time and reduce the number and likelihood of complications.

To remove the appendix, three small incisions are made; after they heal, barely noticeable scars remain on the skin. Most often, you can be discharged from the hospital within a few days after surgery, although it may take 1-2 weeks to fully recover.

Open appendectomy

In some circumstances, laparoscopy is not recommended. Then it is appointed instead open surgery— laparotomic appendectomy. It is carried out:

when the appendix ruptures;
for tumors in the digestive tract;
women in the first trimester (up to 13 weeks) of pregnancy;
people who have already had abdominal surgery.

In these cases, the appendix is removed through a large incision in the abdomen. After laparotomy, more than noticeable scar, and it takes a week for you to get stronger and be able to leave the hospital.

Both minimal intervention surgery and open surgery are usually performed under general anesthesia, meaning you will be asleep during the operation.

Complications of appendicitis

If the appendix ruptures, pus from it spreads to other abdominal organs, which can cause inflammation of the abdominal cavity, called peritonitis. Peritonitis is purulent inflammation abdominal cavity. Because of this, it is disrupted normal operation intestines and intestinal obstruction occurs.

Symptoms of peritonitis:

sharp pain in the abdominal area;
high temperature up to 38º C or higher;

If treatment is not started immediately, life-threatening complications may develop.

Sometimes an abscess forms around a ruptured appendix. An abscess is a collection of pus that is separated from surrounding tissue by the body's immune system's attempts to fight the infection. Abscesses require surgical treatment.

Which doctor should I see if I have appendicitis?

Using the NaPopravku service, find a good surgeon or, if the symptoms are severe, call an ambulance.

Acute appendicitis (OA) is an inflammatory lesion of the appendix in the cecum. In the absence of timely medical care, the disease can cause sepsis, septic shock, abscesses in the liver, etc.

According to the ICD10 classification, acute appendicitis is assigned code K35. On this moment, OA is the most common surgical pathology, while in men the disease is registered two times less often than in women.

According to modern classification It is customary to highlight development:

appendicular colic;
spicy simple catarrhal forms inflammation;
acute destructive forms (acute phlegmonous appendicitis, gangrenous, perforated).

Empyema of the appendix is classified separately. This type of inflammation is similar to acute phlegmonous appendicitis.

Complicated and uncomplicated appendicitis are also distinguished. The most common complications of inflammation of the appendix include the development of:

It should be noted that the division of OA into forms reflects the degree of progression of the inflammatory lesion of the appendix. Each form has its own morphological and clinical features. In this regard, when making a final diagnosis, the forms of inflammation must be indicated.

Causes of appendicitis in adults and children

The exact causes of inflammation are still not fully understood. The most common theory is infectious.

The main route of entry pathogenic microflora is an enterogenous infection. Hematogenous and lymphogenous infections are extremely rare.

The causative agents of appendicitis are various pathogenic and conditionally pathogenic microorganisms, located in the intestine and penetrating into the lumen of the appendix. These can be bacterial agents, viruses, fungi, protozoa.

In children, OA can be caused by helminthic infestations.

Predisposing factors contributing to the development of the inflammatory process are:

the presence of putrefactive processes in the intestines;
pronounced violation intestinal microflora (severe dysbacteriosis, accompanied by a significant increase in opportunistic microflora);
frequent and prolonged constipation;
blockage of the appendix with fecal stones;
the presence of diseases accompanied by hyperplasia of intestinal lymphoid tissues;
unhealthy diet, etc.

The first signs and symptoms of appendicitis in men and women

The first signs of appendicitis in women and men are no different. Manifestations of the disease may vary somewhat, depending on the location of the process, but the main thing is constant symptom there will be pain.

The pain usually occurs at night or morning time. The first pain is noted in the epigastric or left iliac region, etc. Also, the pain can be wandering in nature, that is, it can occur in different parts of the abdomen.

The first pain syndrome is usually mild, constant and dull. Increased pain is observed within two to three hours from the onset of the disease. In this case, there is a gradual shift of pain from the center pain in the right iliac region (Kocher's sign). Subsequently, the pain is constantly localized in this area.

In addition to pain, the first signs of appendicitis in men and women may also appear reflex vomiting(not abundant and not bringing relief). The appearance of vomiting is usually noted in the first hours of illness. Also, with appendicitis, nausea and an increase in temperature to 37.4-38 degrees are noted. The tongue is covered with thick white coatings.

Symptoms of appendicitis in men and women may also include constipation and gas retention. With retrocecal locations of the appendix, loose stools may occur.

Symptoms of appendicitis in women should be differentiated from ovarian apoplexy and acute.

Appendicitis during pregnancy

The leading symptoms of appendicitis during pregnancy are painful sensations in the abdomen, vomiting, fever. However, appendicitis during pregnancy can manifest itself with more subdued symptoms, as well as a late onset of pain. However, in the second and third trimester, on the contrary, a pronounced pain syndrome may be observed, which intensifies when lying on the right side (the pressure of the uterus on the appendicitis increases).

Treatment is also surgical. Removal of appendicitis during pregnancy is carried out in accordance with the gestational age of the child and, accordingly, the displacement of the cecum.

Symptoms and signs of appendicitis in adolescents and children

Symptoms of appendicitis in a child are similar to the symptoms of the disease in adults. However, in children, as a rule, the pain syndrome is more pronounced, symptoms of protective tension of the abdominal muscles (the stomach is like a board), and severe tachycardia increases faster (acceleration of the heart rate). Also, in children it is easier than in adults to experience a lag or complete non-participation of the right side of the abdomen in breathing.

Repeated vomiting is often observed. Body temperature with appendicitis in children can rise to 39 degrees.

The tongue is moist, covered with thick white coatings (with development, the tongue becomes dry, like sandpaper).

Unlike adults, children with appendicitis experience both constipation and diarrhea with almost equal frequency.

How younger child, the more restless he reacts to the examination. Tearfulness, moodiness, and irritability are noted.

Where does a person have appendicitis?

The appendix is a vermiform appendix in the cecum (a section of the large intestine). The appendix is a tubular formation, on the one hand ending blindly, and on the other hand, communicating with the lumen of the cecum (at the point of opening into the cecum there is a Gerlach valve, but in elderly patients complete closure of the lumen may be observed). The inflammatory process in the appendix is called appendicitis.

Visual representation of the location of the appendix

The size of the appendix can vary from two to twenty centimeters, but in most cases, its length does not exceed ten centimeters (most often 3-4 centimeters). The diameter of the appendix normally does not exceed one centimeter. In isolated cases, congenital absence of the appendix may occur.

The cecum itself is located in the right iliac fossa (RIF), in in rare cases its high location is noted (its embryonic location is most rarely noted - under the liver).

The location of the appendix from the cecum always remains unchanged, but its location in the abdominal cavity can vary (descending, lateral, medial, ascending, left-sided, etc. appendicitis).

Most often (about 45% of all cases), a descending origin of the appendix is noted, in which it, together with the cecum, is located in the PPU. In patients with an elongated appendix, it may descend into the pelvis. In this case, with appendicitis, it can grow together with the tissues of the bladder, uterus and rectum.

The diagram shows the location of the appendix

In external lateral locations (approximately twenty-five percent of cases), the appendix is located in the area of the RCA (right lateral canal). Inflammation of such a process often takes on a chronic form.

In patients with the internal medial appendix (about twenty percent of cases), it extends deep into the thickness of the intestinal loops. Inflammation of such an appendix most often leads to the rapid development of severe disease and, in the future, to adhesive disease.

With an ascending or subhepatic location of the appendix, its apex is directed upward (with an elongated appendix up to the subhepatic recess).

Posterior or retrocecal - characterized by the location of the appendix behind the cecum. In the anterior case, it covers the anterior surface of the intestine ( this type location of the appendix is often accompanied by the development of adhesions).

The rarest options for the location of the appendix are intraorgan (in which it is located in the intestinal wall) or left-sided (observed with transposition of internal organs).

What is appendicitis for?

Appendicitis refers only to an inflamed appendix. Therefore, when appendicitis develops, the appendix is surgically removed.

However, normally, the vermiform appendix performs several important functions.

It is capable of producing lipase and amylase, thereby performing a secretory function.
Ensure the production of hormones that regulate intestinal motility and the functioning of its sphincters.
Play the role of an “incubator” for beneficial bacteria, participating in the digestive processes, thereby ensuring digestive function and maintaining normal intestinal microflora.
Perform an immune function (appendicitis is often called the intestinal tonsil) due to the content of a large number of lymphoid tissues. Many authors associate the high incidence of inflammation of the appendix with the fact that its tissues retain and destroy a huge number of pathogenic bacteria.

Can appendicitis go away on its own?

No. Acute catarrhal and destructive appendicitis can only be treated surgically.

Catarrhal inflammation lasts from six to twelve hours, then phlegmonous appendicitis occurs. In the absence of timely medical care, gangrenous appendicitis forms within 24 hours. Rupture of the appendix or its perforation most often occurs on the second day of the disease.

Reversal of inflammation never occurs; therefore, emergency appendicitis removal is performed.

Conservative treatment methods can only be used for appendiceal colic (without the development of simple appendicitis) and chronic appendicitis.

Chronic appendicitis is quite rare and is accompanied by the appearance of a sluggish inflammatory process in the appendix (without previous acute inflammation), the development of granulations, adhesions in it, as well as the appearance of cicatricial deformities, obliteration of its lumen, etc. Chronic appendicitis with persistent pain syndrome also treated surgically.

What does appendicitis look like (pathomorphological picture)

Catarrhal forms of OA are initial stage diseases. In this case, the appendix thickens, swells, and its serous membrane becomes dull. Due to the overflow of blood vessels, a visual picture of bright hyperemia of the appendix appears.

In the lumen of the appendix can be found sanguineous fluid. When the mucous membrane is cut, hemorrhages may be detected.

At microscopic examination Defects in the mucous membrane, areas of leukocyte infiltration, as well as fibrinous plaque can be detected. The muscular layer of the appendix catarrh, as a rule, is not affected.

In rare cases, catarrhal appendicitis may be accompanied by the development of serous effusion in the abdominal cavity.

As the disease progresses, acute phlegmonous appendicitis develops. It is characterized by a sharp thickening of the appendix, pronounced edema, and the appearance of visible fibrinous plaque on the appendix, surface of the cecum, peritoneum, loops small intestine etc. Also, when phlegmonous appendicitis a cloudy effusion containing leukocytes appears in the abdominal cavity. As a rule, the effusion quickly becomes infected.

In case of phlegmonous appendicitis, pus is found inside the appendix. Ulcers appear on the mucous membrane.

The formation of empyema of the appendix is noted when the lumen of the appendix is blocked by a stone, cicatricial deformation, etc. Empyema is considered a variant of the course of phlegmonous inflammation, however, with empyema, inflammation rarely spreads to the peritoneum.

Appears inside the appendix a large number of fetid purulent contents, due to which the appendix is sharply swollen and hyperemic.

Gangrenous appendicitis is manifested by the appearance of areas of necrosis in the appendix. Ulcers of varying sizes and a dirty gray color appear on the mucous membrane. The part of the process affected by necrosis becomes dirty green.

There is copious infected effusion in the abdominal cavity purulent in nature with a fecal odor.

In elderly patients, against the background of atherothrombotic damage to the arteries of the appendix, appendiceal infarction may develop, with fulminant formation of gangrenous appendicitis.

Gangrenous forms of inflammation are often complicated by perforation of the appendix with the outflow of pus into the abdominal cavity and the appearance of diffuse (less often limited) inflammation.

Can you die from appendicitis?

Yes. Inflammation can progress quickly.

Therefore, in the absence of timely surgical care, simple catarrhal appendicitis turns into destructive (phlegmonous, gangrenous, perforated forms), complicated by peritonitis, abscesses, purulent infiltrates, sepsis, etc.

What happens if appendicitis bursts?

Rupture of the appendix is accompanied by the release of pus into the abdominal cavity and the development of limited or diffuse inflammation of the peritoneum (peritonitis).

At the same time, even in the case of the development of a limited infiltrate, its rupture with the formation of diffuse peritonitis is possible.

Article prepared
Infectious disease doctor A.L. Chernenko

Appendicitis is an inflammation of the appendix, that is, the appendix of the cecum. This small organ, who has ceased to participate in digestion, but does something in the body: works part-time in immune system and sometimes gets sick.

Most often it becomes inflamed in people 10–30 years old, but in general you can get sick at any age.

Why does the appendix become inflamed?

It is impossible to say exactly why the appendage of the cecum decided to become inflamed in each specific case, because the reasons are different.

The most common is that the lumen of the appendix closes. A huge number of bacteria live in the intestines, and when the lumen of the appendix is closed, they begin to multiply quickly in one place. Inflammation begins, that is, appendicitis.

Sometimes the cause of inflammation is infections, chronic diseases of the abdominal organs, vascular problems and even injuries.

How to understand that it is appendicitis

Appendicitis is difficult to recognize. Its main symptom is pain, and it will not always hurt on the right side. The fact is that there are not many nerves in the abdominal cavity. Sometimes it is impossible to determine what exactly hurts: there is no point where the pain is concentrated.

Therefore, appendicitis usually begins with pain generally in or around the navel. Then the pain may move to the right, but this is not necessary. The pain is constant and gradually intensifies. Sometimes, after intensification, the pain goes away, but this is not always good: this happens when tissues die, when there is nothing left to hurt.

Other symptoms that, along with pain, will indicate appendicitis:

Lost appetite.
Vomiting is not constant, 1–2 times.
Bloating.
Fever, temperature up to 38 °C.

With these signs you need to consult a doctor.

Before being examined by a doctor, you should not take painkillers, sorbents or any other drugs, or give enemas. Due to self-medication, symptoms may change, making it more difficult to determine appendicitis.

How to check whether there is appendicitis or not

In order not to confuse appendicitis with other diseases, the hospital does a blood test, urine test, and may conduct an ultrasound or other examinations. But first you will be examined by a surgeon. Some symptoms of appendicitis appear upon palpation: the doctor presses on different areas abdomen and can make a diagnosis based on the patient’s reaction.

You can’t put pressure on your stomach yourself and try to feel what’s hurting there. Due to the strong impact, the appendix can, roughly speaking, burst. This will lead to complications.

You can only conduct safe tests on your own:

Cough. When coughing, the pain on the right side will intensify.
Lie in the fetal position (curl up) on your right side. In this case, the pain should subside.
Turn on your left side and stretch your legs. With appendicitis, the pain will become more severe.
Lying on your left side, lightly press with your palm on sore spot, then abruptly release. With appendicitis, the pain will become stronger at this moment.

When you need to act urgently

There is a set of symptoms that indicate the development of complications. This is the so-called acute abdomen:

All this is very, very dangerous symptoms. With them, the cause of the disease is sought in the hospital and on the operating table.

How to treat appendicitis

Acute appendicitis can only be treated with surgery - this is the most safe way get rid of inflammation.

Appendicitis develops quickly, and within a few hours the intestinal wall can rupture. Then the entire contents of the inflamed appendix will enter the abdominal cavity, and this is peritonitis - serious complication, which threatens life.

Therefore, cutting out the appendix is easier and more reliable than waiting to see if other means will help.

How to protect yourself

Unfortunately, no way. Research has not found a direct link between diet, lifestyle and appendicitis. Sometimes inflammation is associated with chronic diseases, constipation and even tooth decay, but there is no convincing data on what exactly leads to appendicitis. Just eat and listen to yourself.