- Causes of chronic appendicitis diagnosis of appendicitis
- Treatment of chronic appendicitis
many years been questioned the existence of such diseases as chronic appendicitis.However, carried out in this field of research suggests that after all such a pathological condition should be allocated in a separate disease entities.The chronic form of appendicitis appendix inflammation is about 1% of cases of this disease.Most often, the diagnosis is young women.
clinical picture of chronic appendicitis different variability and polymorphism, but generally resembles creeping form of inflammation of the appendix.Most often, the patient complained of mild pain paroxysmal or persistent nature in the right half of the abdomen.The pain may be localized in the ileum and in the umbilical region.Often it radiates to the lower back, groin, right thigh.Differences in localization of pain caused by structural features and the location of the appendix in different patients, and the
A detailed survey of the patient can identify the relationship of pathological symptoms with errors in diet.The pain may be aggravated by physical effort, increase intra-abdominal pressure during bowel movements, coughing, sneezing.Most patients have disorders of the chair in the form of constipation, diarrhea.In acute diseases can appear nausea and vomiting.
During physical examination the doctor may detect tenderness in the right iliac region with deep palpation.Often, there are weakly positive symptoms of irritation of the peritoneum and the presence of inflammation in the appendix.So pain tend to persist and even intensify when picked straightened at the knee of the right leg (Obraztsova's sign).body temperature indicators generally remain within the normal range.
aggravation of the pathological process threatens the development of gangrene and perforation of the appendix and requires emergency medical care.Long periappendikulyarnyh indolent inflammation of the tissues can cause the development of adhesive disease or bowel obstruction.to the content ↑
Causes of chronic appendicitis
cause of the disease is the development of inflammation in the wall of the appendix.Depending on the features of etiopathogenesis identify several forms of chronic appendicitis:
- primary chronic - in this case in the appendix at the outset of the disease appears sluggish inflammation that causes an acute form of the disease.The existence of this form of appendicitis is still being questioned.Typically, such a diagnosis is after laboratory and instrumental exclusion of other pathology that could cause pain in the right half of the abdomen;
- secondary chronic - the disease occurs in those patients who have acute appendicitis acquired relapsing course.If the transferred acute inflammation for some reason, was not accompanied by the provision of quality health care, in the process of tissue, its mesentery formed pronounced scarring.Dense adhesions narrow the lumen of the appendix, forming bridges and bends.As a result, when released into the lumen of the appendix cecal it may occur stagnation.
concomitant violation of innervation and trophism appendicular wall reduces the stability of the tissues to bacterial infection pathogens presented in feces large number of microorganisms.There is an inflammatory process unspoken, tantalizing patient years.However, in adverse conditions dormant infection can cause aggravation and cause acute appendicitis.to the content ↑
diagnosis of chronic appendicitis is a difficult task even for an experienced clinician.Typically, to confirm the diagnosis and rule out other diseases need to spend more than one study:
- study of blood - often in patients with chronic appendicitis revealed mild pronounced leukocytosis and even pathological leukocyte formula shift to the left;
- urine - allows you to get the information needed for the differential diagnosis of chronic appendicitis with pathology of the urinary system;
- contrast radiography - during this study can detect obstruction of the appendix opening appendicitis caused by an accumulation of feces, dense fibrous adhesions;
- ultrasound - this method of research is the most informative to identify the signs of an abscess of the appendix.In addition ultrasound of the abdominal cavity helps eliminate pelvic pathology, such as the uterus or ovaries;
- computed tomography - this modern diagnostic method allows to obtain layered images of interest areas of the body the doctor.Due to this it is possible to study in detail the state of the wall of the appendix, its shape, structure, location, condition of surrounding tissues and organs.Undoubtedly, the CT is a highly research that helps to exclude tumors of the abdominal cavity and retroperitoneal space;
- diagnostic laparoscopy - an invasive procedure that allows the specialist to finalize the further tactics of treatment.
Treatment of chronic appendicitis
Currently unified strategy with respect to the treatment of chronic appendicitis has not been developed, but many experts advise to carry out the surgical removal of the appendix.Performing surgery is shown in the presence of severity of adhesions and scar tissue in the wall of the appendix.Implementation of the surgical treatment of chronic appendicitis is also recommended in the first trimester of pregnancy.
Currently laparoscopic technique can be used to perform routine appendectomy.This minimally invasive surgery often gives the surgeon a clear view and allows qualitatively remove the appendix, as amended by the pathological process.However, in some cases, you may need to perform an open appendectomy.This allows the surgeon to thoroughly examine the abdominal organs and remove the appendix is adversely located.