Peritonitis, as one of the most dangerous complications of appendicitis - Appendicitis.net
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What is appendicitis and what are its symptoms?
Appendicitis is a disease that results in inflammation of the appendix. The appendix is the atrophied part of the large intestine. The appendix looks like a hollow, worm-like tube. It forms between the large and small intestines.
The causes of appendicitis can be different. At the moment they are still poorly studied. One of the suspected causes is infection with worms and other parasites. Experts believe that it is very difficult to predict the development of inflammation, as well as to prevent it.
It is known that this disease is much more common in children and young people. This may be directly related to the immune system and its high activity.
When appendicitis occurs in a person, the following symptoms appear:
- acute abdominal pain
The pain is most often localized in the right half of the abdomen, above the inguinal fold. The appendix is most often located in this area.
- heat
The temperature with appendicitis most often rises to 38 degrees.
- nausea, vomiting
Taking painkillers for appendicitis is not recommended. Taking them may affect some symptoms. In this case, it will be more difficult for the doctor to make a correct preliminary diagnosis.
Only a doctor can diagnose appendicitis after the ultrasound results are fully known. You can see from them that the appendix is swollen and blocked. Appendicitis can only be removed surgically.
Etiology
Clinicians identify the most common predisposing factors for this disease:
- ignoring treatment for appendicitis that has occurred;
- acute phlegmonous appendicitis;
- appendix rupture;
- complications after childbirth or abortion;
- pancreatitis;
- acute intestinal obstruction;
- inflammation of the pelvic organs.
Peritonitis can often occur after surgery in the abdominal area. Also, such a complication can be affected by injuries or serious injuries.
Often appendicitis with peritonitis can cause perforation of the walls of the stomach or intestines.
Peritonitis is one of the complications of appendicitis
Appendicitis itself is not dangerous and the operation is not very complicated. But with advanced forms of the disease, a dangerous complication can develop - peritonitis. In this case, there is even a possibility of death. Peritonitis is not just complicated appendicitis, but inflammation of the peritoneum. Most often it occurs precisely after inflammation of the appendix.
The peritoneum is the axillary membrane lining the abdominal cavity. Inflammation of the appendix is accompanied by peritonitis only in 10-15% of cases. Doctors are very afraid of such a development of the disease, since in this case a more complex operation will be required. After it, it will be more difficult for the patient to recover. If a person is in poor health, the consequences of peritonitis can be very disastrous for him.
Prevention
The development of peritonitis in acute appendicitis is not an independent disease, but a type of complication. Therefore, there is no prevention of peritonitis as such. It is important to follow the general rules of maintaining health, and if you have dangerous symptoms, seek help without delay. If acute appendicitis is not treated in a timely manner, peritonitis develops, and if there is a delay, if it progresses, there is a threat not only to the health, but also to the life of the patient!
The main thing in preventing the disease is maintaining the body and immunity at a high level. To do this, it is important to follow a daily routine, alternating sleep and wakefulness, and adhere to the basics of a healthy diet. In the autumn and spring, when the body needs support, it is worth taking a course of multivitamins. Physical condition also requires routine and regularity. Strong physical activity, walks, activity, visiting the fitness room - all this will significantly improve your health and keep you active and vigorous for many years.
The appearance of appendicitis is considered a dangerous disease. If you ignore additional signs, complications arise. Appendicitis with peritonitis, a consequence of advanced primary pathology, often occurs. The complication is accompanied by additional symptoms. If signs of peritonitis are detected, urgent medical attention is required. If treatment is not provided in a timely manner, the disease will lead to death. The risk group includes pregnant women, which is associated with a weakened protective function of the body.
Symptoms of peritonitis
The symptoms of peritonitis are somewhat similar to those of appendicitis, but they are much more severe. With appendicitis complicated by peritonitis, a person usually feels:
- severe pain in the abdominal area
Pain in the lower abdomen increases even with leisurely walking and pressing on the sore spot. A symptom of “imaginary well-being” may also be observed. Over time, the abdominal receptors adapt to pain and the person is able to feel some relief. But this feeling is deceptive, as soon the pain will manifest itself again.
- bloating
- muscle tension in the anterior abdominal wall
- chills, fever, high temperature
- excessive fatigue
- scanty urination
- cardiopalmus
- shortness of breath
- loss of appetite
- severe difficulty with bowel movements
- vomiting
Also with peritonitis, there is an accumulation of fluid in the abdominal cavity.
Vomiting with peritonitis is quite typical. At the very beginning, there may be isolated urges, and then the vomiting only intensifies. In the initial stages of the disease, a person vomits stomach contents. In this case, the vomit has a greenish tint. A little later they acquire a yellowish tint mixed with blood. This is the release of intestinal contents. With peritonitis, vomiting is profuse and does not bring the patient the desired relief.
Diagnostic methods
During diagnosis, palpation is performed. In this case, pain is detected in all parts of the abdomen. Great discomfort occurs when pressing on the right iliac region. When percussion (tapping) of the abdominal wall is performed, the patient feels a sharp pain. Sometimes in some places the doctor hears a dull sound. This occurs due to the accumulation of fluid. When the abdomen is listened to, peristaltic sounds are heard.
A rectal examination can help detect discomfort in the anterior wall of the rectum. Pregnant women and women undergo vaginal examination. In this case, an overhang of the posterior vaginal fornix is detected. During peritonitis, pain occurs when the cervix is stretched.
If peritonitis occurs due to a rupture of the inflamed appendage of the cecum during acute appendicitis, then the process is characterized by a severe manifestation. In this case, the disease proceeds for more than 12 hours until the wall of the appendix perforates. In medicine, this process is called appendicular or loose infiltrate, which abscesses into the subcutaneous tissue. Often patients seek help from a doctor when the abscess opens into the abdominal cavity.
When diagnosing this complication, signs of systemic response syndrome to inflammation are identified, which manifests itself:
- severe metabolic disorders;
- persistent hypotension;
- increasing shortness of breath;
- oliguria;
- CNS disorders.
Treatment of peritonitis
Treatment of peritonitis must be carried out in a hospital under the supervision of the most experienced and competent specialists. It must be urgent.
In case of acute peritonitis and appendicitis, emergency surgery is necessary. Therapeutic methods of treatment in this case are not effective, since the inflamed appendix must be urgently removed and the abdominal cavity cleaned and sanitized. This operation is much more complicated than the classic removal of the appendix. During it, the surgeon not only removes the inflamed area of the intestine, but also treats the abdominal cavity. If there are tears in it, they must be sewn up.
Most often, people who develop peritonitis call an ambulance. They are simply not able to get to the hospital on their own. Some patients are brought to the hospital by relatives. But doctors still recommend calling a qualified medical team, since on the road a person with acute peritonitis may require urgent resuscitation assistance.
How is the disease treated?
The appearance of attacks of pain at home with additional symptoms is a reason to call doctors at home. In a state of inflammation of the abdominal cavity, the patient is not able to independently provide first aid. Due to failure of motor function or protracted course of the disease, doctors may perform resuscitation.
Treatment of peritonitis is carried out only in a hospital setting. Doctors use emergency therapy, which consists of surgery. In the acute course of the disease, classical treatment methods will not have a positive result. An appendectomy involves removing the inflamed appendage, and then cleaning the abdominal cavity. After the operation, sanitation is done. If tears are found after surgery, they are immediately stitched up. To make it easier to rinse and remove pus, the edges of the wound are brought together, which helps to install drainage for rinsing.
After an appendectomy, the patient begins a postoperative period during which fluid and pus may accumulate in the abdominal cavity. Drainage tubes are used for this. After eliminating the purulent discharge, they are removed.
When the operation is performed, complex therapy includes taking antibiotics. Medicines of this type are used to reduce the risk of developing peritonitis or its complications. To cure the disease, the patient is prescribed a strict diet. After removing the inflamed appendix, it is recommended to consume only broth. To maintain body tone, vitamin and mineral complexes are prescribed.
Complications of peritonitis
Peritonitis is a fairly serious disease. Its outcome depends on many factors. Particularly important is the stage at which medical care was provided. The nature of the course of peritonitis and the patient’s health status are also important.
Doctors' forecasts for recovery in this case may vary. With a good set of circumstances and the provision of competent and timely assistance, the patient can expect a full recovery. If assistance is provided untimely and unqualified, even death is possible.
Complications of peritonitis include:
- sepsis
- abscess
- hepatic encephalopathy
- intestinal gangrene
- intra-abdominal adhesions
- septic shock
Despite the achievement of very great heights by modern medicine, the treatment of acute peritonitis is today a big problem. The mortality rate for this disease is about 20%.
Features of the location of the appendix
The retrocecal location of appendicitis is characterized by localization specificity , and the inflammation itself occurs in different abdominal parts, in front or behind the peritoneum.
According to the location of retrocecal appendicitis, there are:
- intramural - the appendix is connected to the posterior intestinal wall;
- intra-abdominal - the appendix is localized between the intestine and the anterior part of the peritoneum;
- extra-abdominal - the accessory part of the intestine is located parallel or perpendicular to the intestinal wall;
- co-abdominal - the appendix is fused with the peritoneum from behind.
The most complex form of appendicitis is when the appendix connects to the abdominal wall and tissues of other organs of the abdominal space.
How to determine
The location of appendicitis is determined solely by medical examination , palpation and ultrasound. Diagnostic methods familiar to typical appendicitis do not always work, since the clinical picture described by patients indicates other diseases of the gastrointestinal tract and hepatobiliary system.
