Appendicitis

Appendicitis

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Appendicitis is acute inflammation of the appendix, a remnant of the embryonic gut, the glove finger attached to the check. The structure of lymphatic tissue enters Appendix producer of Action and smooth muscle of the intestinal wall that, but less developed. In most cases described appendicular lumen obstruction, this being the main cause of the disease. In cases in which intraluminal obstruction is not present is assumed by external compression straps or changes of position which prevents the flow of materials through the lumen. Obstruction occurs as a result of impaired blood perfusion of the organ, its distention, and infection. If inflammation and infection attack appendicular wall, Drill body, forcing local peritonitis or an abscess. Sometimes appendicitis is successfully controlled by the body, and symptoms resolve, surgery is not necessary, these cases are more frequent in elderly and antibiotics. Acute appendicitis can occur very varied, and can mimic any disease acute abdominal pain. The main symptom of appendicitis in the clinical picture is abdominal pain, diffuse, and initially not located in the navel. The next symptom is anorexia, which may progress to nausea and vomiting, fever, constipation or diarrhea with gas, and in late stage, stop for materials and gas transit, and cardio-circulatory collapse. Evolution of disease without surgery, is progressive worsening of signs and symptoms, hence the importance of precocious diagnosis and treatment establishment. The most serious complication is perforation with peritonitis free or fistulization in nearby organs. Sepsis is also a lethal complication. The incidence is low in people with a diet that includes fiber, preventing the formation fecalitilor, accelerate intestinal transit and subtracting faecal viscosity. Mortality rises to 20% in patients older than 70 years, because delay diagnosis. Perforation is common in people younger than 18 years and over 50 years. Overall mortality rate of 0, 2-0, 8% and is attributed to complications of the disease, only surgery.
Pathogenesis Following the appendicular lumen obstruction, there is impaired blood flow to the organ wall aggravated by infection and inflammation. This leads to intraluminal fluid accumulation and swelling, the primary cause of pain experienced. Lymphatic and venous drainage ineffective existing allow bacteria to proliferate and invade the intestinal wall. Appendiceal necrosis occurs, which leads to infection with 12-24 hours of onset puncture. In tervalul varies greatly from patient to patient. Purulent discharge in the vast content leads to the onset of peritonitis the peritoneal cavity, it may be localized or generalized depending on local conditions and body resistance. In favorable conditions grip clamps are formed between neighboring organs, make a dam around the inflamed appendix, appendicular inset. He drug therapy may resolve slowly over 2-3 months. Shirt-front can abceda, abscess opening the peritoneal cavity in the sea. Evolution of pathological lesions may follow three phases: Acute appendicitis, catarrhal congestion- Phlegmon-microabcese-parietal acute appendicitis that may conflict and open lumen Acute gangrenous appendicitis-inflammation, cause arterial thrombosis with parietal necrosis, which can be followed by peritoneal perforation.
Causes The most common cause is occlusion of the appendicular lumen, achieved through: -Faecal, nuts, fruit Lifoizi-follicle hyperplasia associated with other infectious and inflammatory diseases: Crohn's disease, gastroenteritis, ameobioza, respiratory infections, mononucleosis -Obstruction of the lumen by intestinal parasites, foreign bodies, tuberculosis, tumors. Tunorale extrinsic compressions, changes of position that prevents flow through the lumen materials or post-surgical clamps are rare cases.