Appendicitis: signs in adults. Signs of acute appendicitis in adults

Appendicitis (appendicitis) is an inflammatory process of a small vermiform appendage of the cecum called appendix. The word "appendix" in Latin means "appendage", and the ending "itis" indicates inflammation.

According to statistics, among all surgical diseases appendicitis spreads about 89% of cases in terms of frequency of spreading and comes first. More often it occurs in people of young able-bodied age from 18 to 35 years. The prevalence of this disease in women is 2 times higher than that of men.

Classification

Appendicitis can occur in acute and chronic form. The acute form is divided into the catarrhal course of the disease and destructive, which, in turn, can take several forms:

• Phlegmonous;
• Phlegmonous and ulcerative;
• Apostematous;
• Gangrenous.

Chronic appendicitis are also divided into several forms. He can be:

• Residual;
• Primary chronic;
• Recurrent.

All these forms of chronic appendicitis are distinguished by sclerotic and atrophic processes occurring in the vermiform appendage. There can be a proliferation of granulation tissue in the walls of the appendix and its lumen, the formation of adhesions between the surrounding serous membranes. In the case of accumulation in the lumen of a vermiform appendage of serous fluid, a cyst develops.

Appendicitis in children and adults: causes, symptoms and treatment

Very often, the patient pays attention to the abdominal pain not immediately, but after a few hours or even days. This is due to the fact that the first signs of appendicitis in adults develop gradually and are of an uncertain nature. There are difficulties in determining the specific area of pain localization. When taking pain medication, pain can completely subside and be felt only with sudden movements and deep inspiration or coughing.

Appendicitis: signs in adults

• Constant pain, which in the first few hours is localized in the navel area, then descends to the right.
• Nausea and vomiting once.
• Raise body temperature to subfebrile.

If these symptoms (signs) of appendicitis in adults are manifested, then do not expect that everything will dissolve by itself. We need to call an ambulance. An experienced team of doctors will easily identify such a dangerous disease that requires immediate hospitalization, like appendicitis. The signs in adults, as already mentioned, can be blurred. To clarify the diagnosis before the arrival of doctors can conduct self-diagnosis.

This is done as follows: in the lower region of the abdomen on the right, you need to press strongly with two fingers (middle and index), and the pain should not be felt. Then the fingers are removed and the pain increases sharply. If such a test was positive, i.e. Everything turns out as described, besides, nausea may occur, and in some cases, vomiting, then, most likely, these are the first signs of appendicitis in adults. Now let us describe them in more detail.

Symptomatics

With the diagnosis of appendicitis, the signs in adults can be somewhat blurred, but they all boil down to the following:

1. First, there is pain in the abdomen, which is clearly not localized. It can manifest itself in the navel, epigastric region or have a blurred character (throughout the abdomen). The pain is constant, sometimes it can be cramping. After an hour or a little more, it concentrates in the lower abdomen on the right. This symptom of the movement of pain is called Koher-Volchkova. Irradiation of pain is usually not observed. This is possible only with an atypical location of the appendix. In this case, pain can be given to the groin or lumbar region.
2. In patients, as a rule, there is no appetite. This symptom is called anorexia.
3. After the pain, nausea develops, and there may be a single vomiting. These signs of appendicitis in adults are reflex and develop due to irritation of the peritoneum.
4. The subfebrile temperature may rise , but it does not always happen. Such signs of acute appendicitis in adults like temperature, vomiting and anorexia are called Murphy's symptom.

When such signs appear, the patient can suspect acute appendicitis. Sometimes these main symptoms of appendicitis in adults are accompanied by frequent urination, stool disorders (diarrhea), frequent pulse and, in rare cases, increased pressure. Other uncharacteristic symptoms of this disease can be observed in the elderly, children and pregnant women, as well as at an atypical location of the appendix of the cecum. What signs of appendicitis in adults are observed most often, we considered. Now let's talk about the features of the development of this disease in women, and also consider what kind of danger it bears during pregnancy.

Features of appendicitis diagnosis in women

In the representatives of the fair half of humanity the probability of an error in the diagnosis of this disease is higher than that of men. This is due to the fact that sensations in the development of this disease can be confused with pain during menstruation or painful reaction in the occurrence of an inflammatory process in the gynecological area of the pelvic organs. This error can occur when the appendix is atypical.

To clarify the final diagnosis in a medical institution, a woman besides a surgeon should also be examined by a gynecologist. A distinctive symptom of inflammation of the appendix from the pathology of the gynecological is the fact that in the latter case, vomiting, nausea and upset of the stool are not characteristic.

Symptoms of appendicitis in pregnant women

Signs of appendicitis in adult women are the same as in men. The exception is made by pregnant women. According to statistics, the incidence of appendicitis during pregnancy is about 5%. A representative of the beautiful half of humanity, who is preparing to become a mother, can have an atypical form with this disease (in case of the displacement of the appendix).

Diagnosis of appendicitis during pregnancy usually does not cause difficulties. Symptoms are the same as in other adults. Difficulties may occur in the last trimester of pregnancy, if the nature of the pain is cramping. Patients, as a rule, take the forced position of the body lying on the back with the legs bent in the knees and pulled up to the abdomen. Pain is localized most often to the right in the ileum region, but in later terms of pregnancy it can appear higher. Also in recent months of pregnancy, appendicitis and postoperative rehabilitation are worried. Therefore, it is extremely important to correctly diagnose.

Causes of appendicitis during pregnancy

This ailment arises due to the fact that during the period of gestation the baby the greatly enlarged uterus can act on the cecum and change its position. Also, the appendix may be impaired by an enlarged uterus, as a result of which blood supply is impaired. This sometimes leads to an inflammatory and even gangrenous process. The cause of appendicitis in pregnant women is also a change in the hormonal background. During the gestation of a child, women often have stool disorders, namely constipation, which can also provoke this pathology.

What is the risk of appendicitis during pregnancy?

Obviously, any surgical intervention, especially when carried out in the abdominal cavity of a pregnant woman, can cause miscarriage or premature birth. But besides this, it is dangerous with the following states:

• Development of fetal hypoxia;
• Placental abruption and premature aging of the fetus;
• The onset of acute intestinal obstruction;
• Postoperative infection;
• Violation of the contractile activity of the uterus during childbirth;
• Development of bleeding in the postpartum period.

Thus, we examined all possible symptoms of appendicitis and signs of disease in adults. Now we pay attention to the peculiarities of the development of this disease in children.

Symptoms of appendicitis in older children

Symptoms in children of older school age are similar to those of adults. It can only be added that such patients often occupy the forced position of the body, in which the intensity of pain is reduced. They lie on your back or right side. In addition, the temperature rises to 38 degrees and even higher. Pulse does not correspond to parameters of increase in body temperature and is much faster.

When examining the oral cavity a moist tongue is noted, on which white coating is present. A bad sign is a dry tongue. This may indicate the development of gangrenous disease and peritonitis. At children of this age at the given disease the delay of a chair can be observed.

Symptoms of appendicitis in young children

In children, the signs of the ailment in question can be suspected in the following cases:

• The child cries and does not give an inspection.
• The right leg pulls the baby to the stomach and curls up.
• The temperature in small patients with a diagnosis of appendicitis often rises above 38 degrees, can reach up to 40.
• The pulse is frequent and corresponds to the rising temperature.
• The stool is thin and frequent.
• Micturition can be painful and rapid. When urinating, the baby cries.
• In young children, vomiting can be repeated.
• The child is restless, refuses to eat, can not sleep, constantly asks for a drink.

What signs of appendicitis in adults and children exist, we now know. Consider the possible dangerous consequences of this ailment.

Complications

In some cases, the course of the disease is complicated by the following processes:

• Abscess of the abdominal cavity, which can be appendicular, subdiaphragmatic, intercigitic or Douglas, depending on the site of localization;
• Thrombophlebitis of pelvic or iliac veins, this can cause a very serious condition - PE;
• Peritonitis, in case of rupture of the appendix;
• Formation of a postoperative infiltrate;
• Development of adhesive process in the postoperative period, which can provoke intestinal obstruction.

Treatment

If signs of inflammation of appendicitis are present in adults or children, it is shown as soon as possible to make appendectomy, i.e. Removal of the appendix in order to avoid serious complications of this disease. This operation is carried out in an emergency order - no later than an hour after the exact diagnosis was made.

At the stage of pre-hospital care, bed rest is recommended. Categorically forbidden to eat any food and drink. Do not take painkillers, laxatives and other medicines until the final diagnosis is clarified, apply cold or heat.

Once an accurate diagnosis of appendicitis is established (signs in adults and children are described above), the patient is placed in the surgical department and appendectomy is performed. This operation in uncomplicated flow is done by laparoscopic method.

After that the patient is transferred to the intensive care unit for several hours, where he is under constant supervision of medical personnel. After the patient completely leaves anesthesia, he is transferred to the surgical department. On the 5th day, stitches are usually removed and the patient is transferred to outpatient treatment.

With a complicated course of the disease, the patient remains in the clinic, and his discharge will be postponed until the unwanted consequences are eliminated and the general condition is stabilized.

Forecast

With an uncomplicated course of the disease and a timely and correctly performed operation, the appendicitis of a life threat does not represent. Full capacity of the patient is restored after 4 weeks.

The causes of complications in appendicitis are usually untimely hospitalization and delayed operation. In especially severe cases, this can even lead to death.