Acute catarrhal appendicitis

Catarrhal appendicitis refers to the initial stage of changes in the mucous layer of the appendix. In this case, the inflammation is mainly superficial, which means that it does not affect deep tissues, but develops in the epithelial cells.

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Epidemiology

According to statistics, this disease is one of the most common in the field of surgery (approximately 90%). The initial stage lasts about twelve hours. After that, the disease transforms into phlegmonous appendicitis. The disease occurs regardless of the patient's age. Appendicitis is diagnosed even in small children.

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Risk factors

Modern medicine cannot give an exact answer as to why this disease occurs. However, specialists identify a number of theories that describe the causes of catarrhal appendicitis:

• the mechanical theory states that the pathology occurs as a result of blockage of the appendix by tumors, parasites or fecal stones, kinking of the appendix or the presence of adhesions in the abdominal area. As a result, the process of removing the contents from the appendix is difficult. The blockage leads to a significant increase in pressure inside the appendix and provokes the occurrence of an inflammatory process of the mucous membrane;
• allergic. According to the theory, allergic reactions of the 3rd and 4th types lead to the onset of the inflammatory process. The protective function of the walls of the appendix decreases and toxic substances or infectious agents can penetrate into it;
• infectious. The theory is somewhat similar to the mechanical one. It says that the onset of inflammation is closely related to infectious agents;
• The vascular theory states that inflammation develops as a result of damage to the appendix vessels by systemic vasculitis;
• alimentary theory. According to this theory, experts believe that the cause of the development of pathology is excessive consumption of meat, as well as a lack of dietary fiber and cellulose in the daily diet. This leads to disruptions in the process of food passage through the intestines.

The main risk factors include bad habits, progression of infectious diseases, poor nutrition, dysbacteriosis, and abdominal trauma.

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Pathogenesis

Since catarrhal appendicitis is exclusively superficial, leukocyte infiltration is present only on the mucous membrane of the appendix. At the first stage, pain occurs around the navel. However, it can migrate.

After several hours, they are localized in the right side and can radiate to the rectum. When walking or when trying to turn to the left side, the pain intensifies.

To date, the causes of the disease have not been fully studied. It is known that its pathogens are various viruses and bacteria that are located in the appendix itself. In children, appendicitis can occur under the influence of helminthic invasion.

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Symptoms catarrhal appendicitis

The symptoms of the disease have many common features with other abdominal pathologies. Since there are several options for the location of the appendix. The presence or absence of complications and the general condition of the patient are also important. However, doctors highlight a number of symptoms that help to recognize appendicitis.

The first signs of the disease:

• pain. This is the most basic symptom that should not be ignored. Often, pain is localized in the right side or near the umbilical area. It is aching and pulling. If the pain spreads throughout the entire abdominal cavity, after about 8-1 hours it begins to localize on the right side;
• high body temperature, constipation or diarrhea. These symptoms occur if the disease progresses;
• vomiting, feeling of dry mouth;
• weakness.

When the first symptoms appear, an adult can immediately contact a specialist. It is much more difficult with small children. If the baby is apathetic, does not play, is lethargic, has a fever, and often touches his tummy, you need to consult a doctor.

A timely diagnosis will help avoid irreversible consequences.

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Stages

Depending on the severity of the pathology, appendicitis has 4 main stages:

1. Catarrhal appendicitis. This is the very first stage, at which the disease manifests itself in the evening or at night. A nagging pain in the stomach area occurs. After a short time, vomiting may occur. The first symptoms resemble gastritis. After a few hours, the pain moves to the right side. When pressed, the patient feels pain, but the stomach itself remains soft. This stage lasts about 12 hours. This is the most favorable time for surgery. However, patients often go to the hospital much later;
2. Phlegmonous appendicitis (24 hours). The pain becomes pulsating, the heartbeat quickens, the body temperature does not exceed 38°. During examination, specialists observe tension on the right side of the lower abdomen;
3. Gangrenous appendicitis. This stage begins approximately on the second or third day, if the person did not manage to seek medical attention in time. Due to the fact that the nerve endings of the appendix begin to die, the pain no longer seems so strong. The abdomen swells, the body temperature drops sharply (less than 36 °C). Severe pain occurs only during palpation;
4. Perforated appendicitis. Towards the end of the third day, a through hole appears in the walls of the appendix. In this case, the person experiences very strong, continuous pain. The abdomen swells, tachycardia may be observed. The coating on the tongue acquires a dark brown tint.

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Forms

Modern medicine identifies several main types of the disease:

• acute catarrhal appendicitis. The pathology received this name due to the rapidly developing inflammatory process. This type is the most common. It is considered the primary form of pathology and occurs in patients regardless of age or gender. The appendix becomes clogged with feces, foreign bodies or parasites. As a result, inflammation occurs, accompanied by aching pain in the lower abdomen;
• secondary catarrhal appendicitis. The disease develops as a result of the inflammatory process spreading from other infected internal organs. The development of the pathology can be influenced by gastric ulcer, inflammation of the gallbladder, diverticulitis, pathologies in the large and small intestines, chronic diseases of the large intestine. This phenomenon is explained by the fact that the appendix is an immune organ.

If the disease was detected at a late stage or was treated incorrectly, it can lead to irreversible consequences and complications: peritonitis, internal bleeding, sepsis, and adhesion formation.

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Diagnostics catarrhal appendicitis

If complaints of pain in the right side arise, the doctor performs palpation. This method allows to determine the presence or absence of inflammation of the appendix. When pressing on the iliac region, a person experiences pain, which intensifies during a sharp tearing off of the hand. There are many points that allow to diagnose appendicitis.

Also, specialists use several effective methods:

1. Sitkovsky's symptom - the occurrence of severe pain when trying to turn onto the left side;
2. Rovsing's symptom. Consists of severe attacks of pain as a result of compression of the sigmoid colon;
3. Moskovsky's Symptom. Involves a slight dilation of the pupil in the right eye.

The patient also needs to submit urine and blood for analysis. Based on their results, it is possible to detect the presence of an inflammatory process in the body.

In order to establish the correct diagnosis, instrumental diagnostics are carried out. It includes:

• radiography;
• ultrasound examination;
• computed tomography;
• MRI.

Instrumental examination is the most effective. It allows to determine with 100% accuracy the presence of inflammation of the appendix in the shortest possible time.

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Differential diagnosis

In addition, at the first symptoms of appendicitis, it is necessary to conduct differential diagnostics. The disease is differentiated from: acute pancreatitis, gastroenteritis, ulcer, cholecystitis, renal colic, pyelonephritis. The pathology also has common symptoms with ectopic pregnancy and ovarian diseases. Additional examinations help to establish an accurate diagnosis.

Treatment catarrhal appendicitis

If the patient complains of pain in the right side and is suspected of having appendicitis, he is hospitalized in the surgical department. After the diagnosis has been established, he is prepared for emergency surgery. Antibiotics are administered for prophylaxis.

The treatment process consists of surgery and a rehabilitation period after it.

Surgical treatment is carried out in several ways:

• laparotomy;
• laparoscopic. This method is the most common and safe for the patient. Small punctures are made in the abdominal cavity, through which the inflamed appendix is removed;
• transluminal. In this case, the incision is made in the vagina or stomach.

In some cases, the disease is accompanied by a dangerous pathology or the appendix is characterized by an abnormal location, so the incision is made in the place where the localization of the appendix was discovered.

If the operation was performed correctly and on time, the prognosis will be positive. The recovery process lasts approximately 7-10 days.

Prevention

Since the causes of the disease have not been fully studied, specialists have not yet developed effective preventive measures. At the same time, doctors strongly recommend not to abuse alcoholic beverages, quit smoking and stick to a healthy diet. It is necessary to eat healthy foods rich in vitamins and minerals. In addition, proper nutrition will help strengthen the body of not only adults, but also children. This will help to avoid the development of various diseases.

Regular physical activity will also not hurt. It is enough to do morning exercises every day.

These rules will help to maintain the nervous, immune and cardiac systems in normal condition. If you have chronic diseases, you should carefully monitor your body and contact specialists if you have the slightest suspicion of appendicitis.

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