Gangrenous form of appendicitis. Causes and treatment of gangrenous appendicitis Diagnosis of gangrenous appendicitis

The reasons can be primary and secondary. In the first case, the disease occurs against the background of other diseases. More often, acute gangrenous appendicitis appears if the purulent form is not treated. Necrotic processes occur within 2-3 days.

Other reasons:

• autoimmune diseases;
• infectious processes;
• violation of the outflow from the appendix.

Primary causes of occurrence - elderly age the patient, thrombosis, as a result of which blood flow is disturbed, as well as congenital vascular pathologies (narrowing of the lumen).

Symptoms

There are no specific symptoms that indicate gangrene of the appendix. Together with tissue necrosis, the death of nerve endings occurs, which is why there is no pain syndrome.

As a result of putrefactive inflammatory processes, symptoms of intoxication appear:

• weakness;
• severe vomiting;
• slight increase in body temperature, chills;
• dry mouth, white or yellow coating on the tongue;
• increased heart rate;
• tightness of the abdominal muscles.

In children, necrotic processes develop faster, so the symptoms can be more severe. You can recognize appendicitis in a child by the following symptoms: lethargy, moodiness, crying for no reason, lack of appetite, pain when pressing on the abdomen, diarrhea. The baby lies on his right side, legs tucked into his stomach.

Which doctor treats gangrenous appendicitis?

It is necessary to consult a surgeon.

Diagnostics

The doctor examines the patient, listens to complaints. Next, the surgeon examines the patient by palpation. It is possible to reveal tension and distension of the abdominal wall, lack of intestinal motility.

To identify the root cause, the doctor looks at the patient's medical history. Next, use laboratory and instrumental methods diagnostics. The first belongs to the general and biochemical analysis blood, urinalysis and coprogram.

In the urine, leukocytes and erythrocytes are detected, which are normally absent. In the blood, the ESR is increased and the level of leukocytes is increased.

Instrumental techniques:

• Organ ultrasound abdominal cavity(with gangrenous-perforated form this technique not informative);
• radiography;
• diagnostic laparoscopy (performed using a laparoscope, which is inserted through a puncture in the abdominal cavity to study the gastrointestinal tract).

Treatment

Treatment of gangrenous-perforated appendicitis is only operative. Surgery to remove the inflamed appendix -. It avoids the consequences of appendix gangrene.

If you remove the inflamed process before the perforation of its tissues, then the probability postoperative complications is minimal. Sometimes the consequence of appendectomy can be the divergence of sutures and wound suppuration. These complications are treated conservatively.

Before having an operation to remove your appendix, you must empty your bowels. There are 2 types surgical intervention:

• Open. The appendix is ​​removed through the peritoneal incision. This type of operation is rarely resorted to, since it is traumatic. The length of the incision is up to 12 cm. After the removal of the appendix, sutures are applied, and pus from the abdominal cavity is removed with the help of drainage.
• Laparoscopy. With a gangrenous form without perforation of the walls of the appendix, laparoscopy is preferred. The process of the cecum is removed through 2-3 small holes. The recovery period is faster, and the likelihood of complications is 3-4 times lower than with traditional surgery.

Postoperative period

After removal of gangrenous inflammation, rehabilitation is important. The hardest postoperative period runs for children and the elderly. To speed up the process, you must follow these recommendations:

• take a course of antibacterial treatment to prevent the development of infectious complications;
• take pain medications;
• undergo detoxification therapy (it is important for complicated appendicitis);
• regularly handle and bandage the wound;
• follow a diet;
• take anticoagulants and blockers gastric secretion for the prevention of thrombosis and ulceration;
• take a blood test daily to prevent complications.

To avoid cardiovascular and respiratory problems, you need to do physiotherapy exercises.

Diet is the foundation of recovery from surgical treatment gangrenous-perforated appendicitis. It must be observed for 1.5 months after appendectomy. Basic principles:

• refuse food that irritates the intestines (sweets, spices, fried foods, smoked foods, canned food and alcohol);
• eat 5-6 times a day, fractionally;
• do not eat hot or cold food.

On the first day after the operation, you must completely refuse to eat. You can drink kefir, unsweetened tea and dried fruit compote. On the second day, the patient is allowed mashed potatoes, liquid porridge, chicken broth, rice broth and curd casserole.

Complications

Perforated appendicitis is a consequence of the gangrenous form. At untimely treatment there is a perforation of the walls of the appendix. In this case, the contents of the appendix are released into the abdominal cavity. The next stage is purulent peritonitis.

Symptoms of the perforated form:

• sharp regular pain in the right iliac region, which later spreads throughout the abdomen;
• increased body temperature;
• bloating;
• violent vomiting without relief;
• tachycardia;
• brown coating on the tongue.

In addition to perforation of the appendix, other serious consequences are possible: peritonitis, internal bleeding, formation of fistulas, abscesses, septic thrombophlebitis, self-amputation of the appendix (arbitrary separation of the appendix).

If an appendicular infiltrate is formed, remove appendix it is possible only after the infiltration has resolved.

Prophylaxis

There are no specific preventive measures. In order not to develop a purulent form, it is necessary to timely treat diseases that can cause gangrenous appendicitis. The patient should be examined regularly.

The prognosis for gangrenous appendicitis is favorable. After removal of the inflamed appendix, the person continues to live full life... With the development of complications, there is a possibility lethal outcome.

Useful video about appendicitis

One of the very dangerous forms acute appendicitis- gangrenous, proceeding with destruction (destruction) of the walls of the appendix. It can also be called a complication of acute in case of failure to provide timely treatment... According to statistics, gangrenous appendicitis occurs in almost 9% of all cases acute forms and can often be the cause of a sad outcome.

The most important reason for its development, which occurs in most cases, is a violation of the blood supply to the appendix. Any violation of microcirculation leads to oxygen starvation of tissues, a change in their metabolism, to ischemia, due to which their necrosis (necrosis) develops. The addition of the infectious component of inflammation leads to gangrenous appendicitis.

This pathology can occur at any age. In the elderly and senile period, it develops against the background of systemic atherosclerotic vascular lesions, and in the appendix as well. In the nursery and young age- against the background of congenital vascular anomalies. In each age period gangrenous appendicitis is possible due to the formation of blood clots in the appendicular veins and arteries.

Violation of the drainage of the appendix and stagnation of intestinal contents in it, accession bacterial infection many times increase the likelihood of gangrenous changes. In addition, the development of necrosis and gangrene of the appendix can occur without initial vascular changes and be a consequence of acute purulent form.

Clinical manifestations, diagnosis

Gangrenous appendicitis can be suspected by some of the symptoms. The spread of necrotic changes in the tissues of the appendix also affects the nerve fibers and endings, therefore, after severe pain in the abdomen, the patient feels their weakening or complete cessation. General state remains severe: intoxication of the body intensifies, nausea, vomiting becomes repeated.

But in practice, these changes in the clinical picture are rarely recorded, and the diagnosis of gangrenous appendicitis is made during surgery. The appendix is ​​visualized greatly increased in size, with loose walls, tearing at the slightest manipulation, having purulent overlays, areas of necrosis (light) and gangrene (dark).

Diagnosis of purulent appendicitis, including gangrenous form, is based on the patient's complaints. These are severe pains in the right side of the abdomen, fever, nausea and vomiting, and stool disorders. On examination, a sharp soreness and tension of the abdominal wall is revealed. V clinical analysis blood - sharp leukocytosis, significant increased ESR, shift leukocyte formula towards young forms.

ESR - erythrocyte sedimentation rate, an indicator used to identify inflammatory processes in the body.

Some diseases can create a similar clinical picture, so it is important to conduct differential diagnosis... It is carried out in relation to peptic ulcer stomach or duodenum, acute cholecystitis, acute pancreatitis, adnexitis, Crohn's disease, intestinal diverticulosis.

Treatment

Diagnosis of any form of acute appendicitis is an indication for emergency surgery, since delay leads to life-threatening complications. Contraindications to surgical treatment there is no purulent appendicitis. In each case, the method of operation is selected: open appendectomy or laparoscopy.

The earlier the patient asks for help, the less likely the transition of the purulent form of the disease to the gangrenous one and the subsequent rupture of the appendix. If the removal of the inflamed process is not performed on time, then the consequences of gangrenous appendicitis are very dangerous. This is perforation (wall rupture) with the ingress of purulent masses and intestinal contents into the abdominal cavity and the development of peritonitis, the formation of multiple abscesses, general blood poisoning (sepsis).

Peritonitis is an inflammatory process that occurs in abdominal area... Peritonitis is characterized by high mortality- 15-19% off the total cases.

Diagnostics of the gangrenous-perforated form of appendicitis is carried out, as a rule, already in the provision of emergency surgical care. This requires the further use of special tactics both during the operation and in the postoperative period.

Postoperative period

The tactics of postoperative management of a patient with gangrenous appendicitis concerns both drug therapy, and adherence to the strictest diet. The main directions of treatment are the appointment of powerful antibiotics, infusion therapy for detoxification (blood substitutes) and prevention of blood clots.

Diet after surgery for gangrenous appendicitis is of fundamental therapeutic importance. Eaten foods should not only be balanced in proteins, fats and carbohydrates, but also have a minimal irritating effect on the intestines, and also be in the most assimilable form.

After surgery, the intestines cannot peristalize normally and move the food masses, the intestinal villi do not absorb nutrients enough. The task of the diet is to carefully and sparingly restore everything intestinal functions in a short period.

On average, a strict diet is required within 2 weeks after surgery. With each new postoperative day, the range of permitted products expands, but the basic dietary principles remain unchanged. It is a mechanical, physical and chemical sparing of the mucous membrane. gastrointestinal tract... Therefore, all dishes should not be in the form of large pieces, but pureed, not too hot or cold. Of the methods of processing products, boiling and steaming, less often baking, is allowed. For the purpose of chemical sparing, any seasonings, caffeine, carbonated drinks are completely excluded. An important principle is fractional meals (5-6 times a day) in small portions.

By the end of the first day after the operation, it is allowed to drink a glass of water or weak broth. On the second day - vegetable puree, boiled and mashed chicken, jelly. Natural yoghurts are allowed from the third day, meat broths, a variety of boiled vegetables and cereals. In the second week, milk and dairy products, baked vegetables and fruits, fish and steamed lean meats.

Gangrenous appendicitis is a vital dangerous condition... Timely operation, competent management of the postoperative period in compliance with special diet- these are the main conditions for the preservation of the patient's life and his recovery.

The inflammation that occurs in the appendix is ​​called appendicitis. As it develops, the disease goes through several stages from an easy, corrected drug treatment, to difficult. Gangrenous appendicitis is a type of appendix lesion and the penultimate stage of the disease, dangerous in that it often leads to the death of a person.

In this position, the use of surgery is not a salvation. As a result of the action of the surgeon, a violation of the integrity of the appendix may occur. The process bursts and the pus contained inside enters the abdominal organs. Peritonitis develops sharply, tissue necrosis occurs.

This stage of appendicitis does not occur immediately, but 2-3 days after the first signs of the disease appear. During this period, signs of phlegmonous-gangrenous changes in the tissues of the organ appear. Lack of therapy leads to a deterioration in the patient's condition and the development of complications. The inflamed organ changes, the outer walls collapse, die off. During the operation, there is a rotten smell from the wound. The appearance of the appendix has characteristic signs last stage:

• Significant increase in size;
• The color of the appendix has changed and has taken on a dirty green tint;
• Areas with blood are observed;
• Tissue necrosis is visible;
• Sources of pus oozing.

Danger acute defeat the appendix is ​​that it affects the internal organs located close to the appendix. In particular, inflammation affects the organs located in the abdominal cavity. If medical attention has not been received, gangrenous appendicitis turns into a gangrenous-perforated ailment, the organ wall becomes perforated, and pus seeps out.

Gangrene of the appendix develops more often due to the lack of adequate treatment on the third day. Lightning-fast development (6-12 hours) of the penultimate stage of appendicitis is extremely rare. It can also be seen in young children when the immune system formed incompletely and cannot resist the inflammatory process.

The reasons leading to the onset of the disease:

• Patient's age and vascular system... With age, pathological changes occur in the vessels, contributing to a decrease in the quality of the supply of the process with oxygen and nutrients, and the outflow also worsens. venous blood... The development of a primary gangrenous type of ailment often occurs.
• The appearance in the arteries passing through the intestinal tract, cholesterol plaques (atherosclerosis) leads to an insufficient amount of blood flowing to the intestinal tissues.
• V childhood incomplete development of the vessels passing through the appendix is ​​capable of provoking gangrene of the appendix. Hypoplasia in a child is a congenital ailment.

• The development of thrombotic disease in the veins and arteries that supply and drain blood in the cecum.

Insufficient blood supply leads to oxygen starvation of organ tissues, they begin to die off. The rapid onset of the penultimate stage may be associated with ingestion of an infection or the course of autoimmune processes in the lumen of the intestinal tract.

Symptoms

Acute appendicitis in the gangrenous stage will be characterized by a special clinical picture... The perforated form of the disease increases the intoxication of the body, more and more decay products are released into the blood (the tissue dies and releases toxins). The following symptoms appear:

• Loss of appetite and aversion appearance food.
• The patient is constantly shivering.
• The body temperature rises, the thermometer shows 39 degrees. It should be noted that this does not always happen.
• The state of nausea and the occurrence of vomiting.
• The patient's stool is disturbed. Periods of constipation can be followed by periods of diarrhea.
• V oral cavity a plaque appears on the tongue that has white, yellow or Brown color... The color change is noticeable near the root.
• The intestines produce more gas and the stomach becomes hard.
• The patient feels weak throughout the body and fatigue.
• Dry mouth.
• The pulse quickens and reaches 120 beats in one minute.
• In young patients, there is a lethargic state and moodiness, tearfulness.

There comes a period when the patient feels that he is better, but this is only temporary relief, which is a false indicator of recovery. This means that along with the tissues of the appendix, the nerve endings responsible for pain die off.

Perforated ailment

Dying tissue leaves behind small holes in the walls of the appendix. Medicine this phenomenon highlighted as separate and dangerous species gangrenous appendicitis, requiring certain methods of treatment, surgery and further care in the period after surgery.

A perforated appendix is ​​painful. When tissue rupture occurs, the patient experiences an intense pain syndrome on right. At first, the pain manifests itself in attacks, but gradually turns into chronic stage and radiates over the entire area of ​​the abdomen.

Effects

Absence medical care with the onset of gangrene of the appendix leads to a significant deterioration in the patient's condition and the development of complications:

• Pylephlebitis develops inside. This means that a purulent inflammatory process provokes the formation of blood clots in the portal vein.
• The appearance of purulent sources in the peritoneal cavity. As a rule, an abscess is located between the intestines, in the area of ​​the diaphragm and small pelvis.
• A tissue infiltrate begins to form around the appendix. Its formation prevents the spread of inflammation to other internal organs.

The most dangerous complication the gangrenous form of peritonitis is considered. This means that there was a rupture of the walls of the appendix. This development of the disease is fraught with blood poisoning. Surgeons try to prevent the onset of this stage, since the survival rate of patients is low.

Period after surgery

The selected method of appendectomy, the severity of the disease determine the duration of the postoperative period. On the first day after the gangrenous type of appendicitis and its removal, the patient is looked after by a nurse. It does the following:

• Observes the patient and records the appearance of symptoms of internal bleeding.
• It measures the temperature, thereby monitoring the condition of the operated person.
• Periodically examines the seam site.
• Conducts a patient survey about sensations, appetite. Monitors the frequency of bowel movements.

The postoperative period of patients with remote appendicitis of the gangrenous type has some features and will differ:

• The patient is prescribed drugs that have a strong antibacterial effect: Cephalosporin, Amikacin, Ornidazole, Levofloxacin.
• The patient is prescribed analgesics. These medications are taken as needed.
• To support the body, various solutions are injected intravenously: saline, glucose, albumin, rheosorbilact, fresh frozen plasma.
• Preventive measures are taken to prevent the formation of blood clots in the vessels. Prevention is directed against the occurrence of ulcers of the stomach, intestines against a background of stress. The operated person wears elastic bandages on his shins, he is injected with anticoagulants. Medications are taken that reduce the production of bile secretion: Omez and Kvamatel.
• A blood test is taken every day.

• Bandaging the wound. Dressings are changed daily, the wound is washed, the drainage system is disinfected. At the same time, healing is assessed and purulent discharge appears.
• Passage of therapeutic procedures: exercise therapy, breathing exercises, massage. The duration and number of procedures is determined by the patient's condition. The sooner all the functions of the body are activated in a person, the faster and more successful the recovery process will be.

Compliance diet food in the postoperative period - a factor of early recovery:

1. For the first 24 hours after the appendectomy, you cannot eat, only drink. The water must be clean, mineral, without gas. You can also consume weak sweet tea, compote, fat-free kefir. You can eat grated low-fat soup or chicken broth. There are a few, but often.
2. Second 24 hours. Mashed potatoes, mashed lean meat are added. They add to the menu: casserole with cottage cheese, boiled sausages, porridge boiled in water.
3. On the following days, diet number 5 is prescribed. Exclude spicy, smoked, pickles, pickles from the diet. Eat a little, but often.

Complications

Carrying out surgery before the perforation of the walls of the appendix occurs, reduces the risk of complications. In this case, an infection occurs at the seam site and the appearance of pus. Treatment of these complications does not require repeated surgery.

When a patient comes to the surgical table with purulent-looking peritonitis, the following consequences are possible:

• Not only pus enters the abdominal cavity, but also fecal matter.
• There is a separation of the appendix from the body of the cecum.
• Multiple formation of small purulent wounds in the small pelvis, in the diaphragm.
• The appearance of infiltration. This factor becomes an obstacle to surgery. Only after resorption of the formation can appendicitis be removed.
• Peritonitis with purulent formations.

Acute gangrenous appendicitis is one of the most dangerous forms of inflammation of the appendix. Most often, it develops as a result of untimely access to a doctor and incorrect diagnosis. In fact, this is a continuation of phlegmonous appendicitis.

Gangrenous changes in the appendix can also be of primary nature, for example, if the initial cause of the disease was thrombosis or spasm of the mesenteric vessels of the appendix.

Pathomorphology of the disease

Gangrene of the appendix is ​​the destruction of all layers of the organ wall, their melting and necrosis. During the operation, a serous or purulent effusion with a sharp putrid odor is found in the abdominal cavity. The appendix has a dirty green color, increased in size, areas of necrosis and multiple hemorrhages are visible.

With gangrenous appendicitis, the surrounding organs are actively involved in the inflammatory process. Adhesions form between the omentum, intestinal loops and the peritoneum, hemorrhages and fibrinous plaque appear on the surface of these organs. Often there is self-amputation of the appendix or its perforation, that is, through perforation of the wall.

The removed appendix has greenish color, increased, foci of necrosis and hemorrhage are observed

Symptoms of the disease

All types of appendicitis are similar in terms of symptoms, but each of the forms has its own characteristics. This also applies to acute gangrenous appendicitis. If it is a consequence of phlegmonous inflammation of the appendix, then the pain subsides or even disappears. This is due to the death of nerve endings in the walls of the appendix as a result of necrosis. In patients, multiple vomiting appears due to high intoxication of the body, while in other forms of the disease it is absent or single. Other signs of appendicitis are described in the video at the end of the article.

Important: for any symptoms of appendicitis, you must immediately call an ambulance.

During the examination, the doctor may note dryness of the tongue, tension of the muscles of the abdominal wall. On palpation, right iliac region sharply painful. In the analysis of blood, the level of leukocytes is moderately increased, although the shift in the formula to the left is significant.

Why is appendix gangrene dangerous?

With gangrenous appendicitis, the most formidable consequence is diffuse peritonitis. It develops when there is an outpouring of putrefactive contents from the appendix into the abdominal cavity. Sometimes it is limited (localized), if adhesions manage to form, which prevent the process from spreading. This complication is characterized by a sharp change in the clinical picture. The pains are no longer localized. They intensify and spread to the entire abdomen. The patient's condition is rapidly deteriorating:

• tachycardia is observed (pulse rate is more than 100-120 per minute),
• a white coating appears on the tongue,
• consciousness becomes lethargic, inhibited,
• the stomach ceases to participate in the act of breathing,
• there is repeated vomiting, which does not bring relief.

For gangrenous-perforated appendicitis, the absence of intestinal peristalsis is characteristic, the abdomen is tense, and there are signs of irritation of the peritoneum. Paralytic may develop intestinal obstruction... In the analyzes, the number of blood leukocytes significantly increases, the ESR rises to high numbers (40-60 mm / h), there is a sharp leftward shift in the leukocyte formula. In the urine, protein and casts (waxy, granular) are often found, which indicates toxic nephritis.

With peritonitis, there is no parallel between tachycardia and body temperature - fever is rarely high. On plain radiograph In the abdominal cavity, fluid levels in the intestinal loops ("Kloyber's cups") are visible.

Treatment of the disease

The main method of treatment for gangrenous appendicitis is emergency operation... If peritonitis is suspected, open laparotomy is performed under general anesthesia... The abdominal wall is opened along the midline, the inflamed appendix and its parts are removed, and the abdominal cavity is examined. Be sure to carry out a toilet internal organs and the abdominal cavity, washed it with an antiseptic solution. The surgical wound is not completely sutured, leaving drainage tubes in it. They are necessary to remove accumulating exudate and irrigate the peritoneum with antibacterial agents.

Drainages are taken into the operating wound - special tubes or rubber strips

Surgery is usually complemented by drug therapy... To eliminate the phenomena of intoxication, infusion solutions are injected intravenously, antibiotics are prescribed.

Postoperative complications

With gangrenous appendicitis, the postoperative period is long and rather difficult. The following complications may occur:

• the formation of infiltration,
• suppuration of the surgical wound,
• external or internal bleeding from a wound
• abscesses in the abdominal cavity,
• intestinal fistulas,
• divergence of the sutures of the operating wound or the stump of the appendix,
• peritonitis.

Important: the listed complications can be with any form of appendicitis, but with gangrenous they are more common. That is why it is impossible to delay calling a doctor and self-medicate.

A worm-shaped segment and a typical clinical picture, which makes it possible to differentiate it from other forms of the inflammatory process directly in the appendix. Most often, it is acute and provokes the development of rather serious health consequences. That is why it is so important to promptly seek help from a doctor who will determine the causes of the pathological process and prescribe therapy.

General information

Gangrenous appendicitis is a type of purulent inflammation of the appendix, which is based on irreversible destruction. Most often, changes of a necrotic nature are observed in small areas of the appendix. Gangrenous inflammation is a form acute option disease and appears only at a certain stage of its development (2-3 days of inflammation).

The main reasons for the development of pathology

Acute gangrenous appendicitis develops when the inflammatory process in the appendix is ​​not noticed during the first day. Then the normal sensitivity of the nerve endings disappears, so the pain syndrome may disappear. Many patients decide that the danger has passed, they can postpone the visit to the doctor for a while. This neglect of one's own health can lead to peritonitis.

Experts attribute the following to the main occurrence of such a pathology:

• Elderly age.
• The formation of blood clots.
• Atherosclerosis of the intestinal arteries.

All these factors indicate that immediate causes development of pathology are the so-called microcirculatory disorders. Their result is considered to be a violation of normal blood circulation, as a result - necrosis of the appendix. Other elements of pathogenesis (infection, autoaggression of immune cells) join only secondarily, only aggravating the course of the pathology.

What signs indicate pathology?

V acute period there is repeated vomiting, which constantly exhausts the patient and does not bring the long-awaited relief. Due to the intoxication of the body due to the development of a putrid inflammatory process, the temperature can remain normal or low.

Gangrenous appendicitis manifests itself as toxic scissors syndrome. The patient has severe tachycardia (heart rate about 100 beats per minute), but the temperature does not rise.

The patient's tongue is dry with a characteristic yellowish coating. In the case of primary gangrenous, the following may differ slightly:

• Painful discomfort in the right iliac zone, which suddenly appears and quickly subsides.
• painful.
• The patient's condition is assessed as serious.

If a person does not receive adequate and timely treatment, after this form of the disease, gangrenous-perforated appendicitis develops. Pathology is characterized by perforation of the wall of the appendix itself. During the period of its immediate rupture, a person experiences severe pain, which over time begins to gradually spread throughout the abdomen. Due to the growing intoxication of the body, the temperature rises, an obvious tachycardia appears. The tongue becomes very dry, the plaque becomes brownish. The patient suffers from severe vomiting.

Diagnostic measures

If you develop any of the above symptoms, you should immediately seek medical attention from your doctor. If this pathology is suspected, the specialist initially conducts a physical examination of the patient. On palpation, as a rule, there is tension in the abdominal wall, the abdomen is moderately swollen. A series of laboratory tests are then ordered, including blood and urine tests. Additionally, it may be required, an X-ray and CT scan... Based on the test results obtained, the doctor can confirm the diagnosis of gangrenous appendicitis.

Treatment methods

Therapy involves the surgical removal of the appendix. Appendectomy is performed the traditional way or through laparoscopy.

In the first case, the doctor removes the appendix through an incision in abdominal wall... Typically, this procedure is performed using general anesthesia.

Operation for appendicitis by means of laparoscopy is characterized by low trauma. The surgeon makes several microscopic punctures in the abdominal wall through which instruments for manipulation are inserted. The most important of these is the laparoscope - a tube with a camera at the end. During the operation, the doctor receives an image from it on the computer screen, which makes it possible to carry out surgical manipulations as accurately as possible.

Postoperative period

The postoperative period in patients with such a fairly common diagnosis has a number of features:

• The use of antibacterial and analgesic drugs.
• Infusion detoxification therapy using saline solutions, refortan, glucose and albumin.
• Daily blood tests.
• Prevention of ulcers and thromboembolic complications. In the postoperative period, patients are prescribed blockers of gastric secretion ("Kvamatel", "Omez"), anticoagulants ("Clexan").
• Daily dressing and washing of wounds.
• Exercise therapy, special massage, breathing exercises.

Surgery for appendicitis is serious enough surgical intervention... To prevent the development of complications in the future, you should use the recommendations below.

Let's talk about nutrition

This pathology is characterized by problems with, therefore, after the operation, special attention should be paid to nutrition.

On the first day, the use of low-fat kefir is allowed, mineral water without gases and light chicken broth. On the second day, if the postoperative period is not complicated negative consequences, you can add mashed potatoes, liquid porridge in water and cottage cheese casserole to the diet. Every other day, the food should be varied as part of the diet number 5. It is better to give up fatty, spicy foods and smoked meats.

Possible complications

This pathology is considered very dangerous, as it can lead to the development of complications that are quite dangerous to health. This process is especially critical for young patients.

What are the negative consequences of gangrenous appendicitis?

1. Purulent peritonitis. This is a rather dangerous condition that requires immediate surgical intervention. If assistance is not provided promptly, blood poisoning can occur.
2. Appendicular infiltration. In the area of ​​the inflamed process, a local conglomerate is gradually formed, consisting mainly of organs and tissues. This problem always requires long-term conservative therapy.
3. Septic thrombophlebitis. Inflammatory process develops in the venous walls. As a result, it leads to the formation of blood clots in the lumen of the vein.
4. Local purulent abscess. Such formations mainly develop in the area of ​​the diaphragm.

Appendicitis should not be ignored. The purulent gangrenous variant of this pathology requires immediate treatment. Otherwise, the likelihood of complications and even death increases. Such inflammation is especially dangerous for children, in them all pathological processes proceed several times faster.