Purulent appendicitis

By appendicitis in medicine, inflammation of the appendix of the cecum is implicated. There are four types of appendicitis: simple, catarrhal, purulent and gangrenous. The disease can appear in both a small child and an adult.

The appendix stores a large number of microorganisms that are responsible for the normal functioning of the immune system. In addition, the lymphoid tissue accumulates inside the organ, which serves as a food for the beneficial bacteria that inhabit the intestine. Thanks to this, useful microorganisms begin to multiply intensively.

The appendix is ​​not an extra organ of our body, without it the work of the immune system worsens. This leads to the fact that a person becomes more vulnerable to infectious diseases. The disorder of this small organ leads to intestinal dysbiosis.

Purulent appendicitis is a common disease characterized by pronounced clinical symptoms. The pathological process is characterized by the development of destructive changes in the process itself and nearby tissues. It is also associated with high risks of complications, for example, peritonitis - inflammation of the abdominal cavity.

Most often, purulent appendicitis is diagnosed in young people from twenty to forty-five years old. In advanced age, the disease can cause death. Women suffer from inflammation of the appendix, almost twice as often as men. Why does the inflammatory reaction develop, how does it manifest itself, what consequences does it lead to? We'll talk about these and other issues in this article.

The true causes of

The true causes of purulent appendicitis are still being studied by scientists. There are several theories, among which can be identified mechanical, infectious. Vascular and endocrine. As for the mechanical theory of origin, physicians argue that the inflammatory response may be the result of occlusion of the lumen in the cecum due to fecal stones, parasites, food slices, lymphoid follicles, neoplasms.

body. In most cases, it is the feces that cause the blockage. Coprolits do not appear at all, the reasons can be connected with individual features of an organism or errors in a food allowance. If a person drinks an insufficient amount of natural water and there are practically no foods rich in fiber in his diet, then the risks of purulent appendicitis increase dramatically.

Errors in nutrition reduce intestinal motility and lead to chronic constipation. This entails poor digestibility of products. A lot of fiber contains vegetables and grain bread. Experts recommend eating balanced, do not overeat and, if possible, eat at the same time.

The mechanism of development of the pathological process is quite simple: because of the blocked lumen of the cecum, blood flow is disturbed, this, in turn, activates the growth and multiplication of pathogenic microflora and the development of an inflammatory reaction. In just two days, this can lead to perforation of the walls of the appendix, necrosis of the tissues and peritonitis.

Now let's talk about the infectious theory of the appearance of appendicitis. Such diseases as typhoid fever, amoebiasis, tuberculosis, can cause a purulent process. Penetration into the body of gram-negative bacteria can also provoke the activation of the pathological process. It's about the E. coli, as well as staphylococcal and streptococcal infections.

Pathogens can penetrate the appendix through the lymphatic vessels and the circulatory system. If we talk about vascular and endocrine theories, it is worth noting that among the experts they did not find broad support. Although it is believed that in old age, inflammation of the wall of blood vessels and their further destruction can cause appendicitis. This is due to the fact that vasculitis narrows the lumen of blood vessels and disrupts blood circulation.

Due to trophic disorders, some cells die, followed by necrotic changes in soft tissues. If to all this the infection process joins, that is, the appendicitis gets pathogens, the tissues begin to rot and decay. It is also believed that the dysfunction of endocrine cells of the APUD system can serve as a catalyst for the development of appendicitis.

Also highlight the predisposing factors in the development of the purulent process:

• elderly;
• weakened immunity;
• abnormalities of the development of the intestine and blood vessels in the region of the appendix;
• autoimmune processes;
• mucosal damage;
• protein diet. Excessive consumption of animal protein provokes the development of putrefactive processes and the violation of evacuation of intestinal contents;
• inflections of the intestine;
• helminthic invasion.

Symptoms of

Symptoms of the disease are almost identical, that in adults, as in children. Symptoms of purulent appendicitis may differ slightly depending on the stage of the pathological process. Consider the typical signs characteristic of all varieties of purulent disease of the appendix:

• acute and intense pains in the abdomen that occur in the evening or at night. Pain syndrome does not necessarily occur in the right ileal region. The appendix can be located both from the side of the back and inside the abdominal cavity;
• first soreness occurs in the abdomen and has a diffuse character. The patient can not name a particular place that hurts him. Over time, the pain begins to localize in the right side in the lower abdomen;
• attack of nausea and vomiting;
• general malaise - nausea and dizziness;
• no stool on the day of the disease;
• dysuria - disorders of urination;
• pain on palpation of the abdomen;
• increased body temperature;
• in severe cases, there are dark spots on the abdomen. This is the focus of necrosis.

Possible consequences of

The resulting consequences of appendicitis are in most cases a consequence of incorrect surgical manipulations. Also, the reason may be the failure to follow medical recommendations and non-compliance with the diet. The most dangerous complication of appendicitis is peritonitis. In this case, the walls of the appendix are ruptured and its contents enter the abdominal cavity.

On the development of peritonitis indicate such symptoms:

• acute unbearable pain in the abdominal cavity. A person can not bend or flex, even breathing increases the painful outburst;
• general symptoms of intoxication - high fever, nausea, vomiting;
• bloating;
• paralysis of the nerve endings of the abdominal cavity, in which the pain response subsides;
• sticky sweat;
• tachycardia;
• fainting;
• toxic shock accompanied by cramps and muscle pain;
• pus spreads, affecting the kidneys, liver, respiratory system;
• constipation or diarrhea;
• renal colic;
• labored urination.

Purulent appendicitis can cause other serious complications, namely abscesses, intestinal obstruction, hepatitis, discrepancy and inflammation of the postoperative wound, septic thrombophlebitis, appendicular infiltration. The list continues to pylephlebitis, blood infection, pleurisy, fistula formation, adhesive process, pneumonia, endometritis.

. The stages of the pathological process of

Acute appendicitis begins with the catarrhal stage. If the pathological process continues to progress, this can lead to destructive changes in the appendix. Let's consider four stages of a purulent appendicitis:

• Phlegmonous.
• Gangrenous.
• Perforated.
• Complicated.

Phlegmonous

Develops in the first day after the onset of the disease. All layers of the intestinal wall undergo lymphocytic infiltration. The appendix is ​​filled with a thick purulent secret. Inflammatory reaction passes to the serous membrane and peritoneum. The patient complains of severe pain in his right side. The temperature reaches 38 or even higher.

Gangrenous

Develops on the second-third day after the onset of the disease. The intestinal wall undergoes diffuse neutrophil infiltration. Body shells are devoid of normal blood supply and innervation. There is a partial death of the intestinal wall. At this stage, patients note a decrease in pain, but this is not an indicator of improvement in the condition, the pathological process begins to progress even more. The symptoms of intoxication are increasing, a fever appears.

Perforated

Breakthrough of the necrotic wall of the intestine results in the pus penetrating the peritoneum. This is the reason for the development of peritonitis.

Complicated

Complications can lead to the death of a patient as a result of septic shock or multiple organ failure. Purulent appendicitis often causes the development of an appendicit infiltrate and an abscess.

Diagnostic examination of

Although the inflammation of the appendix is ​​one of the most well known, its detection in some cases may involve some difficulties. This is due to the lack of characteristic symptoms at an early stage of the purulent process. If suspected of developing appendicitis, the patient is assigned such studies:

• examination;
• abdominal digital examination. Palpation can reveal swelling and pain syndrome;
• general blood and urine analysis;
• analysis of feces - coprogram;
• gynecological examination for women;
• ultrasound examination of the abdominal cavity;
• in some cases requires CT, laparoscopy, radiography.

Features of the treatment process

Treatment of the purulent process is a complex and step-by-step measures. The main goal of therapeutic therapy is to stop the inflammatory reaction and prevent dangerous complications. Recently, doctors have resorted to laparoscopic surgery. An inflamed organ is removed through small holes made in the lower abdomen.

But some forms of purulent appendicitis require a complete cavity operation, so a decision on the type of surgical intervention is made by a qualified specialist. Usually, laparoscopy is resorted to in a phlegmonous and gangrenous stage of a purulent process.

The essence of this procedure is that the loop at the base carefully removes the process, and to prevent bleeding, the tissue is cauterized. It should be understood that removal of purulent appendicitis requires more time than with usual inflammation. For a whole month, the patient is advised not to get out of bed, do not make sudden movements and do not lift weights.

After the operation, antibiotics are prescribed without fail. Also, doctors can prescribe anti-inflammatory, antifungal drugs and immunoglobulins. In some cases, for the removal of toxic substances will require invasive therapy. A major role in the recovery process is played by the postoperative period.

Patients should follow all recommendations, including dietary nutrition. First it is allowed to drink water and weak tea. Liquid food can be consumed on the second day. The food should be fractional, small portions, but often. The patient is considered incapacitated for 30 days.

From the diet, products that irritate the intestines are excluded: spicy, salted, smoked, sour, pickled, etc. It is extremely important to comply with the temperature regime. The food should not be too hot or, conversely, cold.

If purulent appendicitis has been complicated by peritonitis, a strict diet is prescribed, which will have to be observed for several months. The patient will have to eat light vegetable soups without the addition of potatoes, as well as porridges from cereals. Coffee, alcohol, carbonated drinks, of course, are prohibited.

Do not ignore the symptoms of appendicitis and do not take pain medication yourself, so you will smear the clinical picture, which will cause difficulties in diagnosis. After discharge, the patient may be recommended to wear a bandage. Great benefits will come from outdoor walks. Until complete scarring, doing sports is forbidden!

will help. On how much the patient will listen to the doctor's advice, it depends how long it will be restored. The prognosis of the disease directly depends on how much time has passed since the onset of the disease. If you postpone a visit to a doctor, it may be, unfortunately, too late to save a life.

So, purulent appendicitis is a serious disease requiring early diagnosis and timely operation. In no case do not ignore the symptoms of the disease and all the more so do not drown the pain with pills. If you have pain that is accompanied by fever, vomiting, diarrhea, you should immediately consult a doctor.

Treatment does not end with surgery. The rehabilitation period is an important stage of the medical process. Observe all medical recommendations for diet, do not eat prohibited foods. In no case do not lift weights and do not exercise until the end of scarring. Remember, your health is in your hands, so take care of it!