Appendicitis: causes

This disease is an inflammation of the appendix (caecum). It is quite often found in our country. And it is considered the most common disease of the abdominal cavity. Often requires urgent surgical intervention. With a running form or prescription for more than two days, the appendix can burst. In this case, there is a fatal outcome. Therefore, it is very important to diagnose it in time and carry out the operation.

Appendicitis: symptoms, causes of the disease

So, why is it getting worse? We will analyze how appendicitis appears. The causes of the occurrence today are not exactly established. It is difficult to say for what reason the inflammation begins. But studies of the disease show that its development requires two conditions. The first is the presence of the necessary bacteria in the intestine, the second is the clogging of the lumen of the appendage by calories, seeds or various bones. Sometimes foreign appendages are found in the appendix, for example small parts from toys.

The disease begins with pain, but it is usually impossible to determine its distinct position by itself. It seems to a person that his stomach just got sick, but after five hours the pain begins to concentrate in the iliac region of the right trunk. The appendix can generally be placed in different ways, it depends on the individual structure of the body.

In the normal position of the appendage, pain is observed in the right region. If the appendix is slightly higher, then it appears under the ribs, on the right. If the process is located below, the pain will be observed in the pelvic region. In addition, vomiting and sometimes even diarrhea may occur.

There are other symptoms by which you can determine the exacerbation: dark urine, dry mouth (mostly tongue), the temperature rises (often to 40 degrees). During pregnancy, when the woman is lying down, she has pain when turning the body from the left to the right side.

Diagnostics

The causes of appendicitis are still unclear, and it is not so easy to determine them. Symptoms vary depending on the location of the inflamed process. Diagnosis is performed on the basis of blood tests (it contains much more white blood cells) and urine (the amount of protein increases). X-rays are rarely performed, as it does not determine the exact diagnosis. Thanks to the picture, only the stony stone that clogs the opening of the appendage is revealed.

To determine acute appendicitis, ultrasound is additionally done. Sometimes - a tomography on the computer. With its help, the image of the appendix is enlarged. In this case, the intestinal tissues that have changed are also clearly visible.

Complications

One of the most frequent complications is perforation. It can lead to a peri-pendicular abscess (accumulation of infected pus) or to diffuse peritonitis (with the infection of the entire abdominal cavity). The causes of inflammation of appendicitis in acute form: incorrectly diagnosed and delayed treatment.

Intestinal obstruction is much less common. It can occur if the inflammation around the process stops the muscles of the intestines, which prevents the passage of feces. The abdomen swells, and vomiting and nausea occur. The part of the intestine, which is located above the place where the permeability is broken, is filled with gas and liquid.

But the most important and dangerous complication is the infection of blood (otherwise - sepsis). This is a painful condition, when bacteria, getting into the blood, spread throughout the body. Complication can even lead to death.

Treatment

How is appendicitis treated? The reasons for its occurrence can be very different. For example, exacerbation sometimes occurs when complications of diseases of the intestine or stomach. But a simple eating of seeds with husks can also lead to appendicitis. If it is accurately established that it has appeared, then, so that there are no side adverse events, you should not take any laxatives or pain medications, and even more so apply heaters. It is best to put in a place that hurts, something cool and immediately call an ambulance. If appendicitis is confirmed, the process is removed by one of four methods: typical, retrograde, laparoscopic and transluminal.

Postoperative period

With a simple form of the ongoing disease, the patient, even on the first day after the operation, can start to turn a little on the bed, on the second - to sit down, on the third or fourth - to get up. You can take food only from the 3rd day, and it should be liquid or mushy. From the sixth day onwards, they usually switch to diet food.

Children's appendicitis

In the first years of his life he is extremely rare. Basically occurs after 7 years. And the initial sign can be a pain in the abdomen. This does not say exactly about this disease, since this symptom can arise for other reasons. However, a visit to the doctor for verification is still necessary. Why else can appendicitis occur? The causes of its appearance may lie in the slagging of the gastrointestinal tract or infection in the body.

This inflammation can be chronic or acute. The last form in children is diagnosed most often. In this case, the child's pain appears suddenly, immediately begins nausea and even vomiting. After a few hours, the pain moves down the abdomen and begins to pulsate near the cecum. When you cough or try to lie down on your left side, it becomes stronger. Thus in a mouth starts to dry, there can be a constipation or diarrhea.

With young children under 7, you need to be very careful with these symptoms, since appendicitis in general is quite difficult. Because they can not tell where and what exactly it hurts.

The causes of appendicitis in adolescents and children. Why does it arise?

In adolescence, the disease is very common. Mostly, exacerbation occurs in the spring or autumn. The causes of appendicitis in children and adolescents: in most cases, the disease occurs due to a decrease in immunity. As a result, the body is not able to resist viruses and bacteria, the vermiform appendage gets an infection that provokes inflammation.

Other causes of appendicitis in children: it can cause a changed diet and abnormalities of the stomach. Often an important role is played by inattentive use of seeds, nuts, berries. Children often swallow the husks, shells, small bones, so parents should carefully monitor them. Also, even ordinary worms can provoke the disease.

Since the children's body is not yet fully formed, it is quite difficult to make an accurate diagnosis. A child develops a disease much faster than an adult. Children become apathetic, there is a sharp decrease in appetite, chills, nausea, constipation and sharp pain in the abdomen. The temperature can rise to 40 degrees.

In adults

Many cases of exacerbation occur between the ages of 20 and 30 years. Often appendicitis occurs in pregnant women who are predisposed to diseases of the intestinal tract and who suffer from constipation. Although the pathology does not depend on sex. Who often has appendicitis? Its causes are approximately the same at any age. However, in children the process is underdeveloped and easily emptied, and in adults it is vice versa. Consequently, the latter suffer from this disease more.

The causes of appendicitis in adults: it can be any intestinal diseases, abdominal trauma, inflammation of the digestive tract or helminthic invasion. In addition, doctors believe that the reason may be the abuse of protein foods.

Acute form

What provokes acute appendicitis? The causes of this form: the first - clogging of the process, the second - getting into it staphylococci, Escherichia coli, streptococci and enterococci. They are interrelated, because in both cases ideal conditions are created for the rapid multiplication of bacteria. In the first case, everything leads to stagnation of the contents and inflammation of the walls of the appendix, and in the second, the appearance of bowing of the intestine and the impossibility of emptying are provoked.

In the West, doctors have identified a separate cause of exacerbation - when the fusobacterium gets into the procession, which causes necrosis in its tissues. Infection develops rapidly and causes purulent and inflammatory processes. In the West, conservative treatment is common, but in Russia it is rarely used.

Other causes of acute appendicitis: yersiniosis, typhoid fever, tuberculosis, amoebiasis, etc. In addition, the process is facilitated by excessive formation of proteins in the body, it leads to their rapid disintegration in the intestine and the beginning of the decay process. Also, a tendency to constipation is given as a separate cause, as a result of which there is no timely evacuation of the intestine, and conditions are created for the rapid growth of bacteria.

Chronic appendicitis

In adults, it is recorded quite rarely, not more than one percent for all cases of appendicitis. The person experiences periodic pains that increase with walking and coughing. With relapse, the symptoms are the same as with acute appendicitis. The temperature of the body is normal or subfebrile. Often such an appendicitis is classified as pyelonephritis, peptic ulcer, chronic abdominal disease.

Purulent appendix

It is an inflammation of the appendix, which combines several types of acute disease. Why does purulent appendicitis occur? The causes can be as follows: the abundance of lymph, weak blood supply, the presence of a crimped narrow lumen, variability in location. In this case, microbes penetrate into the process with hematogenous, lymphogenic or (most often) enterogenic. With this form of inflammation, the flora is polymicrobial.

Stages of the disease

There are several periods:

1. Catarrhal appendicitis (first 12 hours). Typical symptoms are discomfort and pain in the stomach, most often in the evening and at night. Similarity with signs of gastritis. During this period, there is weakness, malaise, but the stomach remains soft, despite the pain when pressing on it to the right.
2. Phlegmonous appendicitis (at the end of the first day). The pain is clearly localized on the right, in the ileum. It is pulsating and quite intense. There is nausea, tachycardia, the temperature rises. The abdomen in the area of the inflamed process is strained.
3. Gangrenous appendicitis (second and third day). There is a withering away of the appendages, a general intoxication in the body, a pronounced tachycardia. The temperature drops sharply, the abdomen swells, there is a lack of peristalsis.
4. Perforated appendicitis (at the end of the third day). Acute and severe pain in the right lower abdomen, intensive its growth. Absence of periods of relief, the stomach is swollen and tense, constant vomiting begins. Plaque in the language instead of white becomes brown. The temperature rises to a critical level. Outcome - purulent appendicitis or a local abscess.

Difficulties in diagnosing

Why is it sometimes difficult to diagnose appendicitis? The reasons for its occurrence doctors still find it difficult to name accurately. The position of the appendage varies. More often it is located in the lower abdomen - in the right area, but can have a mesentery. It is a film that looks like a sheet, attaching an appendage to structures that are in the abdominal cavity. With a long mesentery, the process sometimes shifts noticeably. In addition, it can sometimes be longer than usual.

In some cases, the appendix goes down into the pelvic region, and in women it lies between its joints. It can also be located behind the colon. In such cases, the symptoms are similar to inflammation of various organs (for example, pelvic organs).

It is difficult to determine appendicitis in those situations when a person has other inflammatory processes that can give similar symptoms. Therefore, initially the patient is observed for some time in order to accurately diagnose, since the signs of appendicitis can manifest more typically after a while.