Can appendicitis go away on its own? Inflammation of the appendix - can appendicitis hurt for a week? Self-diagnosis of an attack

In the section on the question About appendicitis asked by the author overgrown the best answer is there is such a cosmic concept " chronic appendicitis".
I know a friend who was taken off the operating table twice without an appendectomy. still alive, appendix with him. for sixty years now.

Answer from Staff[guru]
If the doctors made a mistake with appendicitis,
then you can expect peritonitis - rupture of the appendix, caecum.
At initial stage appendix pains pass by themselves, then they arise again.
This is true. There is a buildup of pus.
Bad doctors if they did not recognize the appendix, if there is one.
But it can also be pain in a feminine way.

Answer from Neurologist[newbie]
I just recently had apendicitis removed) though they started it ... but it also hurt me for a while and passed. A week later I had an attack and I was in the hospital with a ruptured appendicitis. Therefore, there is no need to delay with this, because then such problems will arise from this ...

Answer from Mama Choli[guru]
have chronic appendicitis.

Answer from Konstantin Novokhatsky[newbie]
maybe it's poisoning or really an infection or something with nearby organs
I had this, they thought it was appendicitis, but it turned out to be poisoning. operated in vain
he himself could not pass, unless of course this is the first case
usually with inflammation of the appendix, it ruptures if not cut out in time
with chronic appendicitis, attacks are possible, but if it was once, then it is unlikely that he
if such a situation arises again, it is much better to remove it (it still does not perform any vital important functions) so that in the future, when repeating, be sure that this is something else, but not appendicitis

Answer from DocArmani[guru]
no it's most likely acute appendicitis! it makes sense to doubt the competence of doctors!

Answer from sergey korsakov[guru]
Perhaps you had intestinal infection or poisoning ... so that there are no new exacerbations, drink levomycetin and some kind of enterosorbent, for example, polysorb.

For a number of reasons, an attack of appendicitis may not disappear without surgery. The first symptoms of appendicitis are not so easy to distinguish from other abdominal pains. Typically, appendicitis pain occurs periodically around the navel. Sometimes it is whining.

After 6-12 hours, with the progression of inflammatory processes, the symptoms will change. The pain moves to the area of ​​​​the appendix (usually to the right lower part abdomen, but can focus elsewhere); a person reacts to irritation of the skin in the area of ​​\u200b\u200bthe peritoneum, replete with nerve endings.

Diagnosis of appendicitis

Often the patient has to press on his own stomach; this allows you to determine the place where the pain comes from. With appendicitis, pain is usually felt on an imaginary line stretching from the navel to the upper end ischium. This is the so-called. McBurney's point, named after the American surgeon who first identified it.

However, the pain can also travel to the upper abdomen and lower pelvis, which can lead to misdiagnosis: colic with appendicitis in a woman can be mistaken for pain in the uterus or in the ovaries. Perhaps the doctor will insist on rectal examination; so he will make sure that the pain really comes from the inflamed appendix.

Often the inflamed appendix at the back is in contact with the right psoas. To relieve pain, a person bends the leg, and attempts to straighten it are accompanied by pain. In addition, the muscles of the anterior abdominal wall are compressed to prevent any movements that cause pain.

In the early stages of the disease, it is difficult for doctors to recognize appendicitis in children. Similar symptoms may occur with infection respiratory tract and go with her. Infection of the glands can provoke appendicitis, and if you complain of chest pain, pay attention to whether the stomach hurts.

Help with acute appendicitis

If the pain does not go away within two hours, it becomes more and more intense, accompanied by vomiting, if the patient cannot rise, it is time to contact the doctors without delay. You can take the patient to the hospital yourself - this way he will receive help faster than in the case of calling an ambulance team at home.

Do not give the patient painkillers or soothing drinks. It is possible that he needs urgent operation, and under anesthesia: therefore, his stomach should be free from liquid and food.

Chronic appendicitis

Sometimes a person has extraordinary attacks of appendicitis; they last a day or two each time. If the appendix becomes inflamed, the walls of nearby sections of the intestine seem to envelop it, blocking the path of infection; when the inflammation subsides, the intestinal walls may remain in the same position, preventing the normal passage of food through digestive tract and causing spasmodic pain - colic - in the lower abdomen, in the area of ​​\u200b\u200bthe appendix. So chronic appendicitis will pass itself, unless re-inflammation occurs.

Mortality due to it seems to be low: only 0.2-0.3%, but such insignificant numbers hide about 3,000 human lives that doctors cannot save. And in summer period When many people are in their country houses and far from doctors, it is especially important to be able to distinguish appendicitis from ordinary abdominal pain in order to see a doctor in time.

Blind but dangerous

Appendix - short and thin blind appendix 7-10 cm long, located at the end of the caecum ( initial department large intestine). Like any part of the intestine, the appendix produces intestinal juice, but so little that it does not play a special role in digestion. Therefore it for a long time considered a "mistake of nature" and removed from the sick at the first opportunity. But recently, scientists have found lymphoid cells in the blind process, the same as in the human tonsils. And since these cells have the ability to protect the body from infections, the assumption was born that the appendix is ​​part of immune system.

However, the quantity protective cells in it, as it turned out, it is very insignificant and cannot have a strong effect on immunity. So most experts are still sure that there is no benefit from the appendix, but the harm in case of its inflammation can be significant: acute appendicitis not diagnosed in time can cost not only health, but also life.

Blame your teeth?

Experts do not agree on exact reasons development of appendicitis. However, risk groups are identified.

For example, people suffering from diseases such as chronic tonsillitis, pneumonia, lingering colds, diseases gastrointestinal tract, caries. As a result of these diseases, infections penetrate the appendix through the bloodstream and provoke an inflammatory process there. So that healthy teeth- pledge of health for appendicitis.

There is also a stress theory. It is based on the fact that as a result of excitement, a person experiences sharp narrowing blood vessels and this leads to a sudden bleeding of the appendix and the development of its inflammation.

But most often, the occurrence of appendicitis is explained by clogging of the junction of the large intestine and the appendix, which often happens with constipation and chronic colitis.

How to recognize him?

For most people, the appendix is ​​about halfway between the navel and the right ilium. In this place, with appendicitis, the maximum pain is felt. But if the appendix is ​​raised to the right hypochondrium, closer to the liver, pain will appear in this area. And if the appendix is ​​lowered into the lower part of the pelvis, then in women, appendicitis is easily confused with inflammation of the appendages, in men - Bladder.

When the process is located behind the caecum, when it is wrapped to the kidney and ureter, there is pain in the lower back, it radiates to the groin, to the leg, to the pelvic region. If the process is directed inside the abdomen, then pains appear closer to the navel, in the middle section of the abdomen and even under the spoon.

Pains arise suddenly, without any clear reason . At first they are not too strong - they can still be tolerated. And sometimes, from the first minutes of an attack of acute appendicitis, they become unbearable and proceed like colic.

Pain will torment a person as long as the nerve endings of the process are alive. When will it die, nerve cells die and the pain subsides. But this is no reason for reassurance. Appendicitis Won't "Resolve". On the contrary, the retreat of pain is a reason for immediate hospitalization. Acute appendicitis is accompanied by other symptoms. At the onset of the disease, general malaise weakness, loss of appetite. Nausea may soon occur, and sometimes vomiting, but only once. Typical temperature in the range of 37.2-37.7 degrees, sometimes accompanied by chills. A white or yellowish coating appears on the tongue.

Recognize appendicitis will help simple tricks. But, keep in mind, self-diagnosis must be carried out very carefully.

1 . Lightly tap with the pad of a bent index finger in the area of ​​\u200b\u200bthe right iliac bone - with appendicitis, it always hurts there.

2 . For comparison, also tap on the left iliac region, which in case of inflammation of the appendix will not cause pain. Attention: you cannot palpate (palpate the abdomen with your hands) yourself, there is a danger of tearing the appendix, which usually leads to peritonitis.

3. Try to cough loudly: increased pain in the right iliac region will tell you that you have appendicitis.

4 . Press lightly with the palm of your hand in the area of ​​the abdomen where it hurts the most. Hold your hand here for 5-10 seconds. This will ease the pain a bit. Now take your hand away. If pain appears at this point, this is a sign of acute appendicitis.

5 . Take the fetal position, that is, lie on your right side and pull your legs towards your torso. Appendicitis relieves abdominal pain. If you turn on your left side and straighten your legs, it will intensify. This is also a sign of acute appendicitis.

But this self-diagnosis should be limited. Do not hesitate to see a doctor, because appendicitis itself, and all the diseases that it can disguise as (renal colic, exacerbation of pancreatitis or cholecystitis, peptic ulcer stomach and duodenum, acute inflammation of the bladder, kidneys, female organs) require hospitalization.

How to treat

If "acute appendicitis" is diagnosed, the primary treatment is one - emergency surgery. Currently, there is a gentle laparoscopic method in which the appendix can be removed without a large incision. Unfortunately, in our country, this type of operation is not yet widespread due to the poor technical equipment of hospitals.

the main task postoperative period- avoid complications, such as suppuration postoperative wound. In their occurrence most often there is no fault of the surgeon. And to be this complication or not to be, depends on the state of the appendix at the time of the operation - the greater the degree of inflammation, the higher the risk of suppuration.

If the operation was successful, the sutures are removed for young patients on the 6-7th day and discharged from the hospital. But for the elderly, as well as with chronic diseases (diabetes, hypertension, cardiac ischemia, etc.) the sutures are removed 2-3 days later. After that, it is desirable to fasten the wound with adhesive tape.

Do not take a bath for about a month and do not go to the bathhouse: water and temperature loads on a fragile scar tissue make the seam coarser, wider and uglier. At least three months, and the elderly should not lift weights for six months. Avoid sports activities that cause tension in the abdominal muscles. Try not to catch a cold: it is dangerous for you to cough.

Hard case

If you try to "tolerate" appendicitis, you may experience peritonitis - inflammation abdominal cavity. Its symptoms:

increasing pain throughout the abdomen, nausea, vomiting, in severe cases- drowsiness, lethargy, bluish hue of the face;

pulse up to 120-140 beats per minute, temperature up to 39-40 C;

tongue coated with white, then becomes dry as a crust, lips dry and cracked;

the abdomen is swollen, it hurts in all its parts, but especially on the right side.

Treat only peritonitis. operational way. Moreover, the operation is very complex and lengthy. Unfortunately, it is not always possible to save the patient. That is why, with the appearance of any pain in the abdomen, in no case should you delay a visit to the doctor. As they say, we do not want to scare anyone, but everyone should remember how dangerous appendicitis is.

Secrets of the blind process

The whole truth about appendicitis

This disease has always been surrounded by a mass of conjectures, and polar ones. Someone fearfully listens to any glimpse of pain in the peritoneum - really THIS happened! Others, on the contrary, indifferently brush aside, saying that cutting out appendicitis is the simplest of operations, and there is nothing to worry about. A lot of frivolous or, on the contrary, panic moods gave rise to a whole mythology. Meanwhile, appendicitis is not at all so harmless, but far from being so terrible. Let's try to figure it out.

speculation

It is not necessary to cut out the appendix. He can pass by himself.

In fact

Indeed, sometimes the infection and the inflammatory process caused by it does not spread inside the abdominal cavity, and the symptoms can quickly disappear. After all, our body is able to get rid of inflammation on its own or with the help of antibiotics. It even happens that a period of imaginary well-being sets in: due to inflammation, the nervous apparatus of the process is destroyed, and the pain goes away. But the inflammation remains, threatening with peritonitis.

speculation

The appendix is ​​a time bomb that will explode sooner or later.

In fact

The vermiform appendix - the appendix - is a hollow tube closed at the end, adjacent to the caecum. What it is for is not really clear. According to some versions, this is a rudiment; according to others, it is part of the immune system: the mucous membrane of the appendix is ​​rich in lymphoid tissue, which neutralizes bacteria and toxins. The main thing is that the appendix can never become inflamed in a lifetime and generally not let you know about itself. The state of the body does not change at all even after the removal of the appendix. The incidence of appendicitis is on average 1 case per 200 people. And in women, by virtue of physiological features appendicitis occurs twice as often as in men.

speculation

An attack of appendicitis is always accompanied by a high temperature and pain in the abdomen on the right.

In fact

The symptoms of appendicitis are much more varied. Sometimes nausea and vomiting appear - signs of poisoning due to intestinal obstruction. The temperature may or may not rise. Pain usually first occurs in the upper abdomen, and then moves down and to the right. However, often there are pains in the right hypochondrium, radiating to the back or anus.

speculation

Inflammation of appendicitis cannot be prevented, it occurs With then for no reason.

In fact

No, it leads to real reasons: blockage of the lumen of the appendix with constipation and indigestion, food and any other infections, worms, inflammatory bowel disease, injuries in the abdomen. In general, there are many reasons.

speculation

Doctors often make a guess and cut out a healthy appendix.

In fact

Of course, no one is immune from mistakes. Diagnosing appendicitis is generally not easy - sometimes signs of inflammation of the appendix are more similar to those that appear with inflammation of other organs, such as pelvic organs. Typical reception: the doctor presses on the stomach and then quickly releases, with appendicitis occurs sharp pain. However, there are more reliable methods - for example, a blood test: if there is an infection in the body, the number of white blood cells increases. An x-ray will show inflammation if the cause is a blockage in the lumen of the appendix stool. Ultrasound examination may reveal an enlargement of the appendix or an abscess in it. Most accurate diagnosis put on the basis computed tomography.

speculation

At severe pain before the ambulance arrives, you need to drink a painkiller.

In fact

In no case! You can not take any medications, as it will be more difficult for a doctor to make a diagnosis. You can't eat or drink. A heating pad is categorically excluded, this can lead to the development of suppuration and rupture of the appendix. The only thing that can be done in this case is to attach a plastic bag with ice to the stomach.

speculation

Cutting out the appendix is ​​a breeze.

In fact

In operations, two methods are now used: traditional and endoscopic. In the first case, everything is simpler: through an incision 10 cm long, the surgeon removes the inflamed process, and then sews up the hole in the intestine and the incision itself. In the second case, the appendix is ​​removed using special instruments that are inserted into the abdominal cavity through small holes. The advantages of this method are obvious: reduction of post-operative pain and fast recovery, as well as practically complete absence seam. The risk in both cases is small, but like any intervention in the body, the operation cannot be considered trifling.

speculation

Removing the appendix is ​​fraught with all sorts of complications.

In fact

Complications do occur, although not as often. If appendicitis is limited to the inflammatory process, then the operation usually passes quickly and without complications. Another thing is when the process is partially damaged due to an abscess, in this case, healing is more difficult and the treatment is supplemented by intravenous antibiotics to fight the infection, because it is the cause of appendicitis complications. Another is an abscess, a collection of pus in the area of ​​​​the appendix, it is also removed surgically.

speculation

After surgery to remove the appendix, a starvation diet is necessary.

In fact

This, of course, is not true. But, as after many operations, at first you should not use products that provoke flatulence, because there are stitches on the intestine. Banned soda water, grape and apricot juice, any raw, nuts, dishes from peas, beans, beans, black bread. Light food is recommended: omelettes, kefir, non-acidic and low-fat cottage cheese, broths, chicken. After 2-3 weeks, you can gradually return to your normal diet.

speculation

If the appendix is ​​not urgently cut out, then you can die.

In fact

At the first signs of inflammation, there are two or three days left, but immediately. With an attack of acute appendicitis, the clock counts - there is a risk of an abscess (accumulation of infected pus) or diffuse peritonitis (complete infection of the abdominal cavity). And this is really dangerous.

speculation

Appendicitis in women leads to subsequent infertility.

In fact

There is such a risk, but in neglected cases. Purulent processes in the abdominal cavity can provoke extensive adhesions and obstruction fallopian tubes. After surgery for purulent appendicitis, 14% of women experience infertility. By the way, this important reason do not delay treatment even at the slightest suspected appendicitis..

Tatiana GOYDINA
Mr. "Stoletnik" No. 21, 2013

Why was there blood on the bandage?

Recently I was discharged from the hospital - my appendix was removed. The operation went well, but yesterday I found dried blood on the bandage. I was afraid the seam would come apart. After all, it’s a long way to go to the hospital, I live in the countryside. Tell me what to do?

Evgenia Borisovna
(by email)

The surgeon answers the highest category Alexey Alexandrovich LYUBSKY

— First of all, calm down. It happens that in the area of ​​\u200b\u200bthe seam accumulates not a large number of blood (due to a hematoma), then it spontaneously empties into a bandage. Nothing wrong with that. Feel the seam carefully. If not found on it painful seals, just lubricate it with iodine or brilliant green for several days. But if it hurts to touch the seam and pus appears, then immediately see the surgeon.

Mr. "Stoletnik" No. 22, 2013

Acute appendicitis- one of the most common acute (requiring emergency operation) surgical pathologies, which is characterized by inflammation of the appendix - the appendix of the intestine.

Acute appendicitis: numbers and facts:

• In developed countries (Europe, North America), acute appendicitis occurs in 7-12 out of 100 people.
• From 10% to 30% of patients hospitalized in a surgical hospital for emergency indications are patients suffering from acute appendicitis (takes second place after acute cholecystitis- inflammation of the gallbladder).
• Between 60% and 80% of emergency surgeries are performed for acute appendicitis.
• In Asia and Africa, the disease is very rare.
• 3/4 of patients with acute appendicitis are young people under the age of 33 years.
• Most often, inflammation of the appendix occurs at the age of 15 - 19 years.
• With age, the risk of developing acute appendicitis decreases. After the age of 50, the disease occurs in only 2 out of 100 people.

Features of the structure of the appendix

Iliac and colon they do not connect end-to-end: the small intestine, as it were, flows into the large one from the side. Thus, it turns out that the end of the large intestine is, as it were, blindly closed in the form of a dome. This segment is called the caecum. A worm-shaped process departs from it.


The main features of the anatomy of the appendix:

• The diameter of the appendix in an adult is 6 to 8 mm.
• The length can be from 1 to 30 cm. On average, 5 - 10 cm.
• The appendix is ​​located in relation to the caecum medially and slightly posteriorly. But there may be other location options (see below).
• Under the mucous membrane of the appendix is large cluster lymphoid tissue. Its function is to neutralize pathogens. Therefore, the appendix is ​​often called the "abdominal tonsil".
• Outside, the appendix is ​​covered with a thin film - the peritoneum. It's like he's hanging on to her. Vessels feeding the appendix pass through it.

How can the appendix be located?

Variants of incorrect location of the appendix:

Image	Explanation
	Near the cross.
	In the small pelvis, next to the rectum, bladder, mother.
	Behind the rectum.
	Near the liver and gallbladder.
	In front of the stomach - this arrangement of the appendix occurs with malrotation - a malformation when the intestine is underdeveloped and does not occupy a normal position.
	On the left - with the reverse position of the organs (in this case, the heart is on the right, all the organs are, as it were, in a mirror image), or with excessive mobility of the caecum.

Causes of Appendicitis

The main symptoms of acute appendicitis:

When do you need to call an ambulance for acute appendicitis?

Before the arrival of the doctor, no medicines can be taken. After taking them, the pain will subside, the symptoms of appendicitis will not be so pronounced. This can mislead the doctor: after examining the patient, he will come to the conclusion that there is no acute surgical disease. But the well-being caused by the effects of drugs is temporary: after they stop working, the condition will worsen even more.

Some people, when they begin to worry about constant pain in the abdomen, go to the clinic to see a therapist. If there is a suspicion that the patient acute abdomen”, he is sent for a consultation with a surgeon. If he confirms the fears of the therapist, then the patient is taken away by ambulance to the surgical hospital.

How does a surgeon examine a patient with acute appendicitis?

What might the doctor ask?

• Where does the stomach hurt (the doctor asks the patient to indicate himself)?
• When did the pain appear? What did the patient do, eat before?
• Was there nausea or vomiting?
• Has the temperature risen? Up to what numbers? When?
• When in last time was there a chair? Was it liquid? Did he have unusual color or smell?
• When did the patient last eat? Do you want to eat now?
• What other complaints are there?
• Has the patient had his appendix removed in the past? This question seems trivial, but it is important. Appendicitis cannot occur twice: during the operation, the inflamed appendix is ​​always removed. But not all people know about it.

How does the doctor examine the abdomen, and what symptoms does he check for?

In acute appendicitis, many specific symptoms. The main ones are:

Is it possible to immediately accurately diagnose?

Sometimes it happens that the patient is taken to a surgical hospital, he is examined by a doctor, but even after a thorough examination, doubts remain. In such situations, the patient is usually left in the hospital for a day and monitored for his condition. If symptoms worsen and there is no doubt that acute appendicitis is present, surgery is performed.

Observation of a patient with suspected acute appendicitis cannot be carried out at home. He must be in a hospital, where he will be regularly examined by a doctor, and if his condition worsens, he will be immediately sent to the operating room.

Sometimes it happens that there are bright signs acute appendicitis, and by making an incision, the surgeon discovers a healthy appendix. This happens very rarely. In such a situation, the doctor should carefully examine the intestines and abdominal cavity - perhaps another “disguised” as acute appendicitis surgical disease.

• Gynecological pathologies : inflammation and ulcers of the fallopian tubes and ovaries, ectopic pregnancy, torsion of the legs of the tumor or cysts, ovarian apoplexy.
• Renal colic on the right .
• Acute inflammation of the pancreas .
• Acute inflammation of the gallbladder, biliary colic .
• An ulcer in the stomach or duodenum that goes right through the wall of the organ .
• intestinal colic is a condition that often mimics acute appendicitis in children.

Analyzes and studies in acute appendicitis

Laparoscopy for appendicitis

What is laparoscopy?

What are the indications for laparoscopy in acute appendicitis?

• If the doctor observes the patient for a long time, but still cannot understand whether he has acute appendicitis or not.
• If the symptoms of acute appendicitis occur in a woman and strongly resemble gynecological disease. As statistics show, in women, every 5th to 10th operation for suspected appendicitis is performed erroneously. Therefore, if the doctor is in doubt, it is much more advisable to resort to laparoscopy.
• If symptoms are present in a patient with diabetes mellitus. Such patients cannot be observed for a long time - they have impaired blood circulation, reduced immune defense, so complications develop very quickly.
• If acute appendicitis is diagnosed in an overweight patient with a well-developed subcutaneous fat. In this case, if laparoscopy is not to be performed, a large incision would have to be made, which heals for a long time and can be complicated by infection and suppuration.
• If the diagnosis is not in doubt, and the patient himself asks to perform the operation laparoscopically. The surgeon may agree if there are no contraindications.

What will the doctor see during a laparoscopy?

How is laparoscopy performed for acute appendicitis?

Is it possible to immediately operate on acute appendicitis during diagnostic laparoscopy?

Treatment of acute appendicitis

Surgical treatment of acute appendicitis

Surgery for acute appendicitis is called appendectomy. During it, the doctor removes the appendix - there is no other way to get rid of the focus of inflammation.

Types of surgery for acute appendicitis:

• Open intervention through the incision. It is performed most often, since it is simpler and faster, it does not require special equipment.
• Laparoscopic appendectomy. Executed by special indications(see above). It can only be performed if the clinic has endoscopic equipment and trained specialists.

Medical treatment for acute appendicitis

Patients are given antibiotics before and after surgery.:

In the second half of pregnancy, it can be difficult for a woman to feel her stomach. An enlarged uterus pushes the appendix upward, so pain occurs above its normal location, sometimes just below the right rib.

Reliable and safe method diagnosing appendicitis in a pregnant woman - ultrasound procedure.
The only method treatment is surgery. Otherwise, both the mother and the fetus may die. During pregnancy, laparoscopic surgery is often performed.

Acute appendicitis in a child

Features of acute appendicitis in children under 3 years of age:

• It is impossible to understand if the child's stomach hurts, and if it hurts, then in what place. Little kids can't explain it.
• Even if the child can point to the location of the pain, he usually points to the area around the navel. This is because the appendix is early age located not exactly like in adults.
• The child becomes lethargic, capricious, often cries, kicks his legs.
• Sleep is disturbed. Usually the child becomes restless in the late afternoon, does not sleep and cries all night. This is what makes parents call in the morning " Ambulance».
• Vomiting occurs 3-6 times a day.
• Body temperature often rises to 38 - 39⁰С.

Prevention of acute appendicitis

• Proper nutrition. The diet should include enough dietary fiber(vegetables and fruits), dairy products.
• Timely treatment any infections and inflammatory diseases.
• Fight against constipation.