Acute appendicitis is a fairly common disease, affecting approximately 0.2% of the world's population annually and every seventh person throughout life. It is an inflammation of the epididymis of the rectum. Rarely seen before the age of two years and after seventy, mainly affects young people under thirty years of age.
Appendicitis is more common in industrialized countries, possibly due to a combination of a sedentary lifestyle and an unbalanced diet.
Causes and complications
Inflammation is usually caused by internal obstruction of the appendix due to stagnation of undigested food or hypertrophy of the lymph follicles, which can increase in size in response to a local or systemic infection (mononucleosis, measles, typhoid fever, Crohn's disease, gastroenteritis, respiratory infections, etc.).
The second hypothesis of the origin of appendicitis relates to the juvenile period, since, from the age of thirty, appendicular lymphatic follicles are significantly reduced. For this reason, in adulthood, the disease is associated with accumulations of inorganic salts, the presence of a foreign body (gallstones, coprolites, neoplasms) or parasites.
Whatever the origin of the obstruction, the accumulation of mucus, which continues to be produced and fill the intraappendicular area without finding a way out, increases the pressure inside the appendix. Subsequent mechanical irritation of the pain receptors is responsible for the occurrence of early symptoms associated with appendicitis, such as nausea and visceral pain.
Reduced blood supply and lymphatic congestion contribute to the virulence of bacteria, which usually inhabit the appendix without causing any harm. If the problem is resolved, the process regresses. If inflammation continues, ulceration of the mucous membrane leads to the formation of purulent material (purulent appendicitis). The next step may be gangrenous appendicitis and intestinal perforation with the spread of the inflammatory process to the peritoneum.
Symptoms of appendicitis
The early sign characteristic of acute appendicitis is represented by general malaise, accompanied by fever, abdominal pain localized around the navel. In the next day, pain, which is the main symptom of appendicitis, "moves" into the right iliac fossa (between the navel and the femur). Sometimes the pain is so severe that it forces the patient to take a lying position with bent legs. Often, symptoms also include gastrointestinal disorders - nausea, vomiting, flatulence, diarrhea.
Diagnosis of appendicitis
The diagnosis is based on physical examination, palpation, examination and assessment of the symptoms reported by the patient. As a rule, appendicitis is accompanied by leukocytosis. A blood test may provide additional confirmation of the diagnosis. It should be remembered that the signs of the disease are nonspecific, as they are common to several inflammatory diseases. The risk of confusing acute appendicitis with gynecological pathological forms is quite high, especially in young or pregnant women.
Diagnosis of appendicitis should be early to avoid the risk of complications, which in some cases can be fatal.
Treatment and prevention of appendicitis
The only way out of the situation is appendectomy - surgical intervention, which includes the removal of the appendix. It can be performed in two main ways – laparotomy and laparoscopy.
Laparotomy is a traditional method, performed by cutting about 5 to 10 centimeters near the appendix. Laparoscopic appendectomy is a minimally invasive intervention, performed with the help of three small "holes" - incisions of about one centimeter in size.
The results obtained from these two different methods of appendectomy are almost identical, but the operation performed laparoscopically allows for faster healing, leaving smaller, almost invisible scars. Therefore, when it is possible, surgeons of Bogoliuby MC give preference to laparoscopic appendectomy.
In 35% of cases, appendicitis occurs due to coprolites, which accumulate in the appendix. For this reason, a diet rich in fiber and physical activity significantly reduce the risk of appendicitis.