Inflammation of the wormlike extension of the caecum called appendix or appendix is appendicitis. Because of the abundance of lymph tissue, appendicitis is also called intestinal tonsils. Appendicitis is a small intestinal protrusion through which nutrients do not pass. The appendix is of varying length in the middle from 2 to 25 cm. In children, it is longer than in adults. Inflammation of appendicitis, which is unusual, creates difficulties in evaluating the symptoms and diagnosing the disease. The cavity of the appendix is very narrow. All microorganisms found in the intestinal flora also live here. Appendicitis is usually sufficiently resistant to these microbes. Heavy mucus plugs, intestinal worms, appendicitis being too long, the presence of corners on its walls that make it difficult to move, or the stuck seeds of fruits such as cherries cause the inside of the appendix to become blocked. With the obstruction of the inside of the appendix, fluid accumulates in the lumen of the appendix, microbes begin to multiply and the internal pressure increases. With the increase in pressure, the appendix begins to swell and gradually the blood supply and nutrition of the appendix tissue are disrupted. Then decay and explosion occur. Thus begins the inflammatory process of appendicitis.
What are the types of appendicitis?
The severity of the symptoms and the scale of the disease depend only on the nature of the appendicitis. There are 3 most important types of acute appendicitis;
* Mucus Appendicitis ; Mucous appendicitis is the most common surgical practice. In this type of appendicitis with increased mucus secretion, the appendix is sufficiently inflamed, taut and enlarged. The overlying peritoneum lost its usual shine and became slightly dull. Although mucous appendicitis is the mildest form of the disease, it can turn into pus appendicitis if not treated in a timely manner.
* Purulent Appendicitis ; In appendicitis, pus accumulating in the appendix inner cavity and wall creates many foci of abscesses. Inevitably, peritoneal inflammation develops as these abscesses ulcerate and open out of appendicitis. In the pus type of acute appendicitis, parts of the intestine near the appendix, such as the caecum and small intestine contact area, are also inflamed.
* Gangrene Appendicitis ; Gangrene appendicitis occurs as a result of the occlusion of the appendix vessels by a clot.
What are the symptoms of appendicitis?
Symptoms of appendicitis can make it difficult for even an experienced physician to diagnose.
Abdominal pain, loss of appetite and vomiting are the main symptoms. Their occurrence facilitates the diagnosis.
Abdominal pain is the most valuable symptom of appendicitis. It usually starts around the navel or on the stomach. It is a blunt pain, may decrease and increase. But it never completely disappears. It usually takes 4-6 hours (may vary in the middle of 1-12 hours). Then the pain settles in the lower right region of the abdomen. In some patients, the pain starts in the right lower quadrant and stays there. Depending on the different locations of the appendix, the pain can be felt in the back, right or left groin, or above the bladder and anus.
Nausea and vomiting are a valuable indicator. Nausea is seen in 75 percent of patients. Often the patient vomits if he eats something. In addition to these symptoms, the patient may also have complaints such as constipation, diarrhea and inability to pass gas. However, they are not diagnostic.
Examination findings may vary depending on where the appendix is located in the body. Whether there is an explosion or not also affects the findings. While body temperature remains normal in some individuals, it rises to 37.5-38 degrees in others. The patient’s avoidance of excessive movement and the increase in pain in cases such as coughing and jumping are also valuable in terms of diagnosis. The symptoms of appendicitis are similar to the symptoms of many diseases (such as intra-abdominal lymph nodes inflammation, gastrointestinal inflammation, gynecological diseases, ectopic pregnancy, perforation of the stomach and duodenum, urinary tract inflammation, gallbladder-pancreas inflammation and obstruction of intestinal vessels). For this reason, the experience of the doctor is of great value in terms of evaluating the findings.
What is the incidence of appendicitis?
With the widespread use of antibiotics, the number of appendicitis cases has decreased. Although appendicitis can be seen at any age, it most commonly occurs in the 20-30 age group. While it is seen around 10% in people older than 60 years of age, it is most common in children aged 6-10 years. While the rate of appendicitis is equal in boys and girls before puberty, appendicitis is 2 times more common in boys in the 15-25 age group. In the period after the age of 25, the rate is equalized again.
How is appendicitis treated?
Appendicitis operations are performed from the abdomen and are one of the easiest operations. However, if neglected, especially the bursting of the inflamed appendix can lead to death.
The definitive treatment of appendicitis is surgery. The patient should be operated with closed (laparoscopic) or open appendectomy method and appendicitis should be removed. Patients diagnosed with appendicitis or thought to have appendicitis should not be fed by mouth and should not take pain relievers.
