Acute catarrhal appendicitis

By catarrhal appendicitis is meant the initial stage of changes in the mucous layer of the appendix. In this case, inflammation has a mostly superficial character, which means that it does not affect the deep tissues, but develops in the cells of the epithelium.

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Epidemiology

According to statistics, this disease in the field of surgery is one of the most common (about 90%). The initial stage lasts about twelve hours. After the disease is transformed 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 can not give an exact answer, why this disease occurs. However, experts identify a number of theories that describe the causes of catarrhal appendicitis:

• The mechanical theory states that pathology arises from the clogging of the appendix with tumors, parasites or stool stones, an appendicle bend, or with adhesions in the abdominal region. As a result, the process of removing content from the process is difficult. Blockage leads to a significant increase in pressure inside the process and provokes the inflammation of the mucosa;
• allergic. According to the theory, allergic reactions of the 3rd and 4th type 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 a bit like a mechanical one. She says that the onset of inflammation is closely related to infectious agents;
• the vascular theory says that inflammation develops as a result of the vascular injury of the appendix 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 fiber in the daily diet. This leads to disturbances in the passage of food through the intestine.

The main risk factors include bad habits, the progression of infectious diseases, malnutrition, dysbiosis, trauma in the abdomen.

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Pathogenesis

Since catarrhal appendicitis is extremely superficial, leukocyte infiltration is present only on the mucous membrane of the appendix. At the first stage, painful sensations arise in the vicinity of the navel. However, it can migrate.

After a few hours they are localized in the right side, they can give into the rectum. While walking or trying to turn to the left side, the pain intensifies.

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

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Symptoms of the catarrhal appendicitis

The symptomatology of the disease has many similarities to other abdominal pathologies. Since there are several variants of the location of the appendix. The presence or absence of complications and the general condition of the patient also matters. However, physicians identify a number of symptoms that help to recognize appendicitis. 

The first signs of the disease:

• painful sensations. This is the most basic symptom that can not be ignored. Often, the localization of pain occurs in the right side or near the umbilical zone. It is aching and drawing character. If the pain sensations spread to the entire abdominal cavity, after about 8-1 hours they begin to localize on the right side;
• high body temperature, constipation or diarrhea. These symptoms occur in the case of disease progression;
• vomiting, dry mouth;
• weakness.

When the first symptoms appear, an adult can immediately consult a specialist. Much more difficult with young children. If the baby is apathetic, is not playing, listless, his temperature rises, and he often touches his tummy, it is necessary to consult a doctor.

A timely diagnosis will help to avoid irreparable consequences.

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Stages

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

1. Catarrhal appendicitis. This is the very first stage, on which the disease manifests itself in the evening or at night. There is a drawing pain in the stomach. After a while, vomiting may occur. The first symptoms resemble a gastritis. Within a few hours, the pain moves to the right side. When the patient presses, pain suffers, but the abdomen itself remains soft. This stage lasts approximately 12 hours. This is the most favorable time for the operation. However, patients often go to the hospital much later;
2. Phlegmonous appendicitis (24 hours). The pain becomes pulsating, heart rate increases, body temperature does not exceed 38 °. On examination, specialists observe tension on the right side of the abdomen;
3. Gangrenous appendicitis. The beginning of this stage falls on the second or third day, if a person did not have time to contact the medical institution on time. Due to the fact that the nerve endings of the appendix begin to die, the pain no longer seems so strong. The stomach is swollen, the body temperature drops sharply (less than 36 ° C). Strong pain sensations occur only during palpation;
4. Perforated appendicitis. Near the end of the third day, a through hole appears in the walls of the appendix. In this case, a person experiences very strong unceasing pains. The abdomen swells, tachycardia can be observed. Plaque in the tongue acquires a dark brown hue.

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Forms

Modern medicine distinguishes several main types of disease:

• acute catarrhal appendicitis. Such a name pathology was due to a rapidly developing inflammatory process. This variety is the most common. It is considered the primary form of pathology and occurs in patients regardless of age or sex. The appendix is clogged with calves, foreign bodies or parasites. As a result, inflammation occurs, accompanied by aching pain in the lower abdomen;
• secondary catarrhal appendicitis. The onset of the disease is the result of the transition of the inflammatory process from other infected internal organs. The development of pathology can be affected by gastric ulcer, gallbladder inflammation, diverticulitis, pathologies in the large and small intestine, chronic colon diseases. This phenomenon is explained by the fact that the appendix is an immune organ.

If the disease was detected at a late stage or if treatment was wrong, it could lead to irreparable consequences and complications: peritonitis, internal bleeding, sepsis, adhesion.

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Diagnostics of the catarrhal appendicitis

When there are complaints of pain in the right side, 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 is intensified during a sharp tearing off of the hand. There are many points that allow you to diagnose appendicitis.

Also, experts use several effective methods:

1. Symptom Sitkovsky - the emergence of severe pain when trying to turn to the left side;
2. Symptom of the Rowing. It occurs in severe attacks of pain as a result of squeezing the sigmoid colon;
3. Symptom of the Moscow. It implies a slight dilatation of the pupil on the right eye.

Also, the patient must pass urine and blood to the tests. According to 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 performed. It includes:

• radiography;
• ultrasonography;
• 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, with the first symptoms of appendicitis, there is a need to conduct differential diagnosis. The disease is differentiated with: acute pancreatitis, gastroenteritis, ulcer, cholecystitis, renal colic, pyelonephritis. Also, pathology has common symptoms with ectopic pregnancy and ovarian diseases. Additional tests help to establish an accurate diagnosis.

Treatment of the catarrhal appendicitis

With complaints of pain in the right side and suspicion of appendicitis the patient is hospitalized in the surgical department. After the diagnosis was made, it is prepared for an emergency operation. For the prevention of antibiotics.

The treatment process consists of an operation and a rehabilitation period after it is carried out.

Surgical treatment is carried out in several ways:

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

In some cases, the disease is accompanied by a dangerous pathology or an appendix is characterized by an anomalous location, so the incision is made in the place where the process was localized.

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

Prevention

Since the causes of the development of the disease are not fully understood, specialists have not yet developed effective preventive measures. In this case, doctors strongly recommend not to abuse alcohol, quit smoking and adhere to proper nutrition. It is necessary to eat healthy foods, saturated with vitamins and minerals. In addition, proper nutrition will help to strengthen the body not only adults but also children. This will help to avoid the development of various diseases.

Also do not interfere with regular physical activity. It is enough to do morning exercises every day.

These rules will help to keep the nervous, immune and cardiac systems normal. In the presence of chronic diseases should carefully monitor your body and refer to specialists for the appearance of the slightest suspicion of appendicitis.

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