Classification of appendicitis

Contents of
  • What is appendicitis in adults?
  • Classification of appendicitis depending on the nature of the
  • pathology Types of pathology depending on the complexity of the process
  • Species in children
  • Atypical forms
  • Summary
  • Related videos

Appendicitis is a nonspecific inflammation of the appendix of the appendix of the cecum. The disease can occur in any person, regardless of sex and age, but the maximum incidence of the disease is 20-40 years.

Among acute surgical pathologies, almost ninety per cent accounted for acute appendicitis. According to statistics, urban residents are more likely to suffer from inflammation of the appendix, in comparison with the inhabitants of rural areas. Appendicitis is characterized by a sharp onset.

First the pain has a diffuse character and often appears in the upper part of the abdomen, and after a while it falls into the right lower part of the abdominal cavity. In this case, the muscles of the anterior abdominal wall are sharply tense, and the right side lags behind in the process of breathing.

Pain is exacerbated by pressing the iliac region to the right, followed by a sharp tearing of the hand. If the patient lies on the left side, the painful flare intensifies. The pain syndrome becomes pronounced when the patient raises his right right leg.

Removal of appendicitis( appendectomy) is the only method of treatment of the disease. The variety of clinical symptoms and morphological changes makes it difficult to create a classification that would be convenient for specialists. Consider the types of appendicitis, according to the VI classification. Kolesova.

What is appendicitis in adults?

Appendicitis is acute and chronic in nature. In turn, the acute process is divided into four main groups:

  • appendicular colic with mild clinical symptoms;
  • catarrhal appendicitis is a simple form with superficial inflammation;
  • destructive changes: perforated, phlegmonous, gangrenous;
  • complicated course: abscesses, appendicular infiltration, purulent inflammation of the peritoneum.

Specialists to designate appendicitis use Kolesov's classification

Classification of appendicitis depending on the nature of

The acute process is characterized by severe inflammation and rapidly developing symptoms. The condition requires an early operation. Chronic form is rare. Identify it is much more difficult, but it also requires appendectomy.


The pathological process develops rapidly and is characterized by pronounced clinical symptoms:

  • pain syndrome;
  • nausea and vomiting;
  • constipation;
  • flatulence;
  • high temperature.

Patients are strictly forbidden to warm up their stomachs, take pain with pills, alcohol, hold enemas, and apply laxatives. The patient should be laid and rest.

If symptoms of appendicitis appear, the emergency team

should be called immediately. Chronic

The chronic form is much less common than the acute process. The difficulty in conducting the diagnosis can be caused by a distortion of the nature of the pain, unclear clinical symptoms and the absence of changes on the walls of the appendix.

How does appendicitis start to ache?

The chronic process causes a narrowing of the lumen of the process. It is fraught with accumulation of pus, gases and transudate.

Pain in this case usually has a minor character. Pain syndrome can intensify after eating and exercise. Patients may have diarrhea or, conversely, constipation.

When you feel the walls of the abdomen there are pains in the right side. When trying to raise the right leg, there are unpleasant sensations. The muscle tone on the right side is significantly reduced. When walking, the right leg becomes more tired.

Types of pathology depending on the complexity of the process

The following types of appendicitis according to Kolesov's classification are considered.


Catarrhal appendicitis is the initial stage of the disease. It lasts for twelve hours. Symptoms of the pathological process may be hidden behind the clinic of other abdominal pathologies. The pain starts to bother around the umbilical region and after about eight hours it drops to the right side. Dull or aching pain is characteristic.


In this case, the inflammatory process covers the entire organ. Purulent foci merge with each other and impregnate all its walls. The appendix grows in size. The walls of the intestine swell, thicken and become friable.

The patient's condition deteriorates considerably. The absence of treatment can lead to a breakout of pus. At this stage, the pain passes, but this is a false sign, which should not be rejoiced.

With phlegmonous appendicitis, purulent contents of
are found in the appendix in the appendix. Important! The phlegmonous form is one of the stages of appendicitis. Its average duration does not exceed 24 hours.

At this stage, the symptoms of catarrhal form are increasing, the general condition of the patient is greatly deteriorating. The patient can specify a clear localization of painful sensations. The attack of nausea is worse. General intoxication manifests itself in the form of high temperature, hyperhidrosis, tachycardia, weakness.

The muscles of the anterior abdominal wall are sharply tense, and the right iliac region lags behind in the process of breathing. It is extremely important to conduct timely operative intervention. Otherwise, it threatens the development of serious complications:

  • wall perforation;
  • development of destructive changes;
  • peritonitis;
  • intestinal obstruction;
  • infection of blood, which can eventually end in a fatal outcome.


In this case, the tissues of the appendix are killed. There is a gangrenous process on the second or even the third day of inflammation. The development of this dangerous form can be due to several reasons:

  • later seeking medical help;
  • children's age, in which the pathological process spreads lightly across the body;
  • is an advanced age.

Specialists call the gangrenous form the frequent cause of deaths from appendicitis

People with autoimmune processes, as well as those who have had severe infections, are at risk. Diagnosis of gangrenous appendicitis complicates the ambiguity of the clinical picture. The death of the appendix cells leads to the death of nerve endings, as a result, patients may not feel pain at all.

With gangrenous form, there are signs of poisoning: weakness, nausea, hyperthermia. Vomiting does not bring relief. The tension of the abdominal muscles is maintained throughout the abdominal cavity. A characteristic manifestation of the gangrenous type are "toxic scissors".Against the background of normal temperature indicators there is a pronounced tachycardia.

Appendicular infiltrate

This is a complicated form of appendicitis, which is characterized by the accumulation of inflamed tissues around the appendix. Neoplasm has clear boundaries. The development of complications can be associated with weak immunity, peculiarities of the anatomical position of the appendix of the cecum, the nature of the pathogen.

The most common appendicular infiltrate is diagnosed in adolescents. The disease begins with sudden paroxysmal pain in the navel area. After a few days soreness decreases, while the symptoms of intoxication persist.

With a calm flow of the infiltrate and the presence of the dynamics of its resorption, doctors prescribe conservative therapy. Patients are shown strict bed rest, sparing diet, physiotherapeutic procedures and antibacterial agents of a wide spectrum of action.

Appendicular infiltration can resolve

Species in children

Unlike adults, the disease in children is somewhat different. This is due to the fact that internal organs are still at the stage of formation. The most common and dangerous is acute appendicitis. It is characterized by inflammatory-necrotic changes.

Acute appendicitis can be catarrhal, superficial, and also destructive. Chronic appendicitis is a fairly rare form in children. It is a consequence of the acute process. It is characterized by the development of sclerotic and atrophic changes in the process.

In children under 3 years of age with appendicitis, the following symptoms appear: severe crying, restless sleep, lethargy, refusal to eat, regurgitation, vomiting, pulling the legs to the stomach. Generally speaking, at this age appendicitis appears rarely enough.

In children, the lumen of the appendix is ​​small, and the lymphatic system is not yet sufficiently developed. The outgrowth of the cecum in children hardly resembles the structure of an adult. Children of preschool age become restless, capricious, refuse even the most beloved food.

In adolescents, acute appendicitis manifests in the same way as in adults

Atypical forms of

Atypicality is explained by the fact that the process can be located in different ways. If the organ is located near the bladder and rectum, the patient will be disturbed by severe diarrhea and frequent urge to urinate.

Retrocecal location of

. Occurs more than half of the time. A close presentation of the organ near the right kidney is characteristic. As is known, the muscles of the lumbar region and the ureter are located nearby. This arrangement causes a constant acute pain on the right or in the epigastric region.

When walking, the pain in the hip joint on the right becomes more pronounced. Sometimes a patient can even limp. Nausea and vomiting rarely appear in retro-vascular form, they are more typical of typical manifestations of appendicitis. Atypical location causes diarrhea. Upon examination, the doctor will not see the tension of the muscles of the anterior abdominal wall.

See also:
Signs of appendicitis in pregnant women
How long does the hospital stay after appendicitis?

Medial location of

This is a fairly rare phenomenon that occurs in no more than ten percent of cases. The organ is located near the small intestine. The medial location is characterized by a rapid development of clinical symptoms. It all begins with diffuse pain, fever and severe vomiting. The abdominal muscles are sharply strained. There is a sharp pain. The patient's body is dehydrated.

Pelvic location

The process is located in the pelvis in about twenty percent of cases. This form is more common in women than in men. Pain can be given to the groin. There is diarrhea with impurities of mucus. Urination becomes rapid and painful. Diagnosis in this case is complicated by the lack of tension in the muscles of the abdominal wall.

Most often from atypical forms, there is a retro-vascular location of the appendix of the appendix

Subhepatic location

This form is very rare and often doctors confuse it with cholecystitis or hepatic colic. From the epigastric region, the pain passes to the right hypochondrium. Patients complain of pain in the area of ​​the gallbladder.

Left-hand arrangement of

Occurs when the internal organs are in a mirror position. Characterized by the appearance of pain in the left ileal region. Diagnosis is facilitated after the doctor touches the liver on the left side.


So, appendicitis is acute and chronic. Depending on the stages, it is divided into catarrhal, phlegmonous, gangrenous and complicated. There are also atypical forms, which are characterized by a left-sided, sub-hepatic, medial, pelvic and retro-eccentric arrangement.

According to statistics, people die from appendicitis and often this is due to late seeking medical help. Unusual forms of inflammation can be similar to a variety of diseases, which can mislead even the most experienced doctor.

If you have unusual symptoms, call for an ambulance. Without the appointment of a doctor, do not take medication yourself and do not use thermal procedures that can be fatal mistakes during appendicitis. Timely and competent measures are a pledge of your speedy recovery!