Chronic appendicitis: symptoms and signs. Chronic appendicitis: signs, consequences and treatment are chronic appendicitis if appendix is \u200b\u200bnot

A chronic appendicitis is called the sluggish form of an inflammatory algorithm in the field of a black-shaped process of the rectum. It is usually associated with a previously transferred attack of acute appendicitis, most often occurring in women. Chronic appendicitis is accompanied by characteristic symptoms, but the diagnosis is necessary. It is this will make it possible to determine the causes and subsequent treatment of the pathological condition.

Causes of formation in women

Experts identify three forms with which chronic appendicitis in adults is associated is a residual, recurrent, primary-chronic. The last variety, also called the residual, is found in adults and sometimes in children. It is characterized by the presence in the history of the patient of one acute attack, which ended with recovery without the exercise of surgical intervention.

Chronic appendicitis in a recurrent form is repeated attacks of appendicitis with minimal symptoms at the remission. Some experts pay attention to the presence of primary chronic, or nefped appendicitis. It develops gradually, while there are no sharp attacks preceding it, which are more often found in adults than in children.

The residual species of chronic appendicitis is a consequence of the previously formed attack of this pathological condition. In this case, it should be considered a binding without operational removal of appendix. It is important to understand that after anemia of acute symptoms in the area of \u200b\u200bthe blind intestine, suitable conditions are stored in order to maintain an inflammatory process.

We are talking about spikes, cysts, the inflection of appendix, hyperplasia of lymphoid fabric - all this greatly hampers its emptying.

Given all this, I would like to pay attention to what are the symptoms of chronic appendicitis. It is their timely identification that will give the opportunity to begin treatment as early as possible, which is necessary not only for adults - women or men, but also for children.

Symptoms of the chronic state of appendicitis

Symptoms of chronic appendicitis is characterized by the predominance of implicitly expressed or even blurred manifestations. The presented pathological condition is associated with the presence of a feeling of discomfort and gravity. In addition, chronic appendicitis is accompanied by stupid mining pains in the field of the right iliac part, which may be permanent or to form episodically. Also, such painful sensations are manifested due to physical exertion and any errors in the organization of the diet.

Chronic appendicitis arising from women and men is quite often associated with disorders of the digestive system. We are talking about the attacks of nausea, meteorism, as well as the formation of constipation or diarrhea. Temperature indicators in the overwhelming majority remain optimal. However, sometimes, especially in the evening, it is likely to increase to subfebris.

In the presence of a chronic form of appendicitis, much more varied symptoms can be identified. So, we can talk about the urochpinal complex, namely, the very painful and frequent repetition of urination. Experts reveal a vaginal symptomatic complex in women, namely the strongest painful sensations in the framework of the gynecological examination.

Chronic appendicitis symptoms can be associated with a rectal complex of manifestations, in which significant painful sensations are observed during a rectal survey. Subsequent attacks of the acute inflammatory state of the blind process can manifest themselves symptoms that are associated with acute appendicitis.

Given all this, it is safe to say that chronic appendicitis is such a state that is difficult to identify, based exclusively on symptoms.

That is why to determine a clear and correct diagnosis, it is strongly recommended not only to refer to the specialist, but also to take care of the implementation of the correct diagnostic examination. In addition to making a medical verdict, this will begin to begin an adequate recovery course, which will eliminate the likelihood of the development of complications, critical consequences in women and children.

Diagnosis of the disease

Indirect manifestations of chronic appendicitis can be identified in the implementation of the palpation of the abdomen. We can talk about local pain in the right iliac region, as well as about a positive symptom of exemplary and quite rarely positive symptoms of roving or Sitkovsky. Experts pay attention to patients to the fact that:

• to identify this condition as chronic appendicitis, it is strongly recommended to carry out x-ray irrigoscopy associated in the area of \u200b\u200bthe large intestine. The submitted examination makes it possible to identify the absence or partial filling of the Appendix Barium, slowing down its devastation, which is a direct evidence of changes in the form of appendix, narrowing in the field of its lumen;
• the implementation of colonoscopy makes it possible to reject the presence of any neoplasms in the problem areas in men and women. The conduct of overview radiography and ultrasound allows to achieve such imaging against the abdominal field;
• clinical analysis of blood and urine patient in the presence of chronic appendicitis, in the overwhelming majority of cases, are not associated with any pronounced changes.

With the primary-chronic form of appendicitis, the diagnosis is determined by excluding other probable diseases of the peritoneum organs, which are characterized by similar symptoms. It is necessary to carry out the differential diagnosis of the presented pathological condition with the following diseases: the gastric ulcer, Crohn's disease, irritable intestinal syndrome, chronic form of cholecystitis, spastic colitis.

In addition, speaking of differential diagnosis, I would like to pay attention to the abdominal toad, Iraciniosis and many other diseases, including gynecological women and wicked invasions in children. It is important to take into account that the diagnostic examination should include a complete list of procedures that the diagnosed diagnosis remained as correct as possible. In some cases, a re-examination may be required to determine those or other features of the pathological condition and why signs of chronic appendicitis were formed.

Features of treatment

Special attention deserves how the treatment of chronic appendicitis should be treated. In particular, with an already confirmed diagnosis and sustainable painful syndrome, it is strongly recommended to take care of surgical treatment. We are talking about the removal of a blind process, which can be carried out using an appendectomy in an open method or a laparoscopic method. In the framework of surgical intervention, a full study of the state of the peritoness authorities to identify other probable causes of painful sensations in the right iliac region is also carried out.

The period after surgical intervention must be associated with antibiotic therapy. Remote results after the implementation of a chronic appendicitis operation is estimated as more problematic than, for example, after acute appendicitis. This is due to the development of adhesive algorithms.

In the case when a patient with a chronic form of appendicitis is identified with poorly pronounced symptoms, resort to conservative treatment.

We are talking about the use of antispasmodic medicinal components, the introduction of physiotherapy procedures, eliminating intestinal disorders.

Macroscopic changes in the field of appendix during the chronic form of appendicitis can remain so lubricated that they can be identified exclusively during the morphological examination of the remote proceed. In the event that women or men blind proceeds remain without any changes, there is a chance that the operations can even exacerbate the already present painful syndrome. As you know, it is precisely the basis for the implementation of appendectomy.

The operation is extremely rarely associated with complications, however, for optimal restoration of the body, it is preferably located for some time in the hospital under the supervision of specialists. Special procedures and the use of medicinal components makes it possible to speed up the recovery process and minimize painful sensations. In order for recovery to be even faster, and the probability of complications was minimized, it is necessary to resort to certain preventive measures.

Preventive measures

Correct prevention is a prerequisite not only for women, but also for men. It is she who makes it possible to count on the most rapid restoration of the body. Speaking of prophylaxis, specialists imply a diet, keeping a healthy lifestyle, consumption of a large amount of water. It is very important to normalize the activity of the digestive system to eliminate the likelihood of any changes.

In addition, experts insist on the use of vitamin components, additional medicines that give the opportunity to improve the work of the intestine and the entire gastrointestinal tract.

An equally important element of prevention should consider a timely diagnostic examination and treatment of any pathological conditions that cause disorders.

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1. Is it possible to prevent cancer?
The emergence of such a disease, as cancer, depends on many factors. To ensure full security can not be any person. But everyone can significantly reduce the chances of the appearance of a malignant tumor.

2. How does smoking affect the development of cancer?
Absolutely, categorically prohibit yourself smoking. This truth is already tired of everyone. But the rejection of smoking reduces the risk of developing all types of cancer. 30% of deaths from cancer are associated with smoking. In Russia, the tumors of the lungs kill more people than tumors of all other organs.
The exception of tobacco from his life is better prevention. Even if you smoke not a bundle a day, but only half, the risk of lung cancer is already dropped by 27%, as the American Medical Association found out.

3. Will the extra weight development of cancer?
See the scales often! Extra kilograms will affect not only the waist. The American Institute for Cancer Research found that obesity provokes the development of esophageal tumors, kidney and gallbladder. The fact is that the adipose tissue is not only for maintaining energy reserves, it also has a secretory function: fat produces proteins that affect the development of a chronic inflammatory process in the body. And oncological diseases just appear on the background of inflammation. In Russia, 26% of all cases of oncological diseases of WHO associates with obesity.

4. Do you have a sport to reduce the risk of cancer?
Pay training at least half an hour a week. Sports stands on one stage with proper nutrition when it comes to the prevention of oncology. In the United States, a third of all deaths are associated with the fact that patients did not comply with any diet and did not pay attention to physical education. An American oncological society recommends training 150 minutes a week at a moderate pace or two times less, but more active. However, the study published in the magazine Nutrition and Cancer in 2010 proves that even 30 minutes will be enough to reduce the risk of breast cancer (each eighth woman in the world) is 35%.

5. What affects alcohol on cancer cells?
Smaller alcohol! Alcohol accused of the occurrence of oral tumors, larynx, liver, rectum and dairy glazes. Ethyl alcohol decays in the body to acetic aldehyde, which then under the action of enzymes goes to acetic acid. Acetaldehyde is the strongest carcinogen. Alcohol is especially harmful to women, as it stimulates the production of estrogen - hormones affecting the growth of breast tissues. Excess estrogen leads to the formation of breast tumors, which means that every super sip of alcohol increases the risk of getting sick.

6. How does cabbage help to deal with cancer?
Love broccoli cabbage. Vegetables not only enter a healthy diet, they also help to fight cancer. Including therefore recommendations on healthy nutrition contain a rule: half of the day diet should be vegetables and fruits. Especially useful vegetables related to the cross-color, in which glucosinolates are contained - substances that, when recycling, acquire anti-cancer properties. These vegetables include cabbage: ordinary white, Brussels and broccoli.

7. During cancer of which organ affects red meat?
The more eat vegetables, the less put in a plate of red meat. Studies confirmed that people eating more than 500 g of red meat a week, above the risk of rack of the rectum.

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Fight sunglasses! Women aged 18-36 years old are especially susceptible to melanoma, the most dangerous of skin cancer forms. In Russia, only for 10 years, the incidence of melanoma grew by 26%, world statistics show even greater increase. This accuse equipment for artificial sunburn, and sun rays. Danger can be minimized using a simple tube sunscreen. The study of Journal of Clinical Oncology 2010 confirmed that people who regularly apply special creams sick melanoma are twice as fewer than those who neglect such cosmetics.
The cream should be chosen with the SPF 15 protection factor, to apply it even in winter and even in cloudy weather (the procedure should turn into the same habit as the cleaning of the teeth), and not substitute for the sun's rays from 10 to 16 hours.

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By itself, the stress of cancer does not cause, but he weakens the whole organism and creates conditions for the development of this disease. Studies have shown that constant concern changes the activity of immune cells responsible for the inclusion of the "Bay and Run" mechanism. As a result, the blood constantly circulates a large number of cortisol, monocytes and neutrophils that are responsible for inflammatory processes. And as already mentioned, chronic inflammatory processes can lead to the formation of cancer cells.

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Chronic appendicitis is most often developing in a person after transferred once a sharp inflammation of a heart-shaped process. A similar form of the disease is of young people from 20 and about 40 years old and on the statistical data of women among this group is an order of magnitude more.

Causes leading to the development of chronic form of appendicitis

Unlike the acute development of inflammation, chronic appendicitis occurs very rarely and it is customary to distinguish between three forms of this pathology:

• The residual or residual form is exhibited when the human history had an acute attack of inflammation of the film of the blind intestine ending with recovery without appendectomy.
• The recurrent form is manifested by periods of exacerbation, which develops an acute appendicitis clinic. During periods of remission, the symptoms of inflammation of the process is practically absent.
• Initially chronic or otherwise, the nestless appendicitis recognize the few doctors. Such inflammation is developing gradually, in the history of the patient, it is not possible to identify the attack of acute appendicitis.

In women, there are often chronic appendicitis can be provoked by inflammation in uterine's appendages, as well as hormonal disorders.

In the chronic forms of appendicitis, the organ constantly has a sluggish inflammatory response, leading to various changes in the structure of the organ. The growth of the granulation fabric sites, all sorts of spikes, atrophic and sclerotic changes, the pathological deformation of the process and its battle with a nearby authorities are all the result of a constant inflammatory response in the tissues.

The recurrent form of appendicitis sooner or later leads to extensive inflammation, which in its clinical manifestations and risk of development of the complications group leads to the need for surgery.

The main symptoms of chronic appendicitis

The main features for chronic appendicitis have smoothed symptoms, on which it is almost impossible to immediately set the correct diagnosis. On symptoms of chronic appendicitis, most often indicate the following changes in well-being:

• Pain. Chronic appendicitis is manifested by periodic or constant, neuro-pronounced soreness mainly in the right departments of the abdomen. The atypical arrangement of the body leads to the appearance of pain throughout the abdomen, in the field of navel, liver, sometimes at the bottom left.
• Severity and uncomfortable sensations in the right iliac area.
• Disorders in digestion. Ponos, periodically constipation, felling, swelling of the abdomen All this happens in patients with chronic inflammation of appendix.

Strengthening the subjective sensations may after exercise, sharp change of body position. Dyspex disorders are enhanced if the diet is not observed, that is, the use of coarse food can lead to bloating, nausea, diarrhea. Chronic appendicitis in its symptoms often resembles the inflammation of the intestine, that is, colitis, and therefore a thorough differential diagnosis of these diseases should be carried out. In women, the chronic form of appendicitis is disguised as inflammation of the genital pelvic organs. The temperature for the chronic form of inflammation of the appendix is \u200b\u200bnot characteristic, but some of the patients note the periodic lifting of the hydraulic indicators to 37 and slightly above degrees in the evening.

Chronic appendicitis can be manifested by a number of other symptoms not characteristic of acute inflammation:

• Merethered, that is, painful and rapid urination.
• Rectal - pain is enhanced if the rectum is conducted.
• In women, vaginal - pain occurs with the usual gynecological examination.

With palpation of the belly, pain is enhanced at the bottom right. It is often determined positive when pulling upward right legs leads to an increase in pain. Chronic appendicitis can disturb the person for years, arising during the recurrence of the disease. A sharp attack of inflammation requires surgical intervention. The aggravation of the disease in women often occurs during pregnancy.

Diagnostics

Diagnosis causes difficulties, since the symptoms are smoothed at chronic appendicitis. It is necessary not only to properly diagnose, but also to exclude the pathology of other organs of the abdominal cavity and a small pelvis. The diagnosis is exhibited after a number of surveys, among which are most often prescribed:

• General analysis of blood and urine. In the blood in patients with chronic appendicitis, moderate leukocytosis and the shift of the left leukocyte formula is detected. Urine analysis is necessary to exclude the pathology of urinary organs.
• Radiography with a contrasting agent. This study helps to identify the obstruction of the hole connecting the process with a blind intestine. Also, radiography can show fibrous spikes, clusters of carts.
• Ultrasound Diagnostics reveals the abscess of appendix and allows you to determine the pathology of the ovaries and the uterus in women.
• CT is the most informative, modern method of examination. When tomography, the organ is examined in layers, which allows you to determine the thickness of the walls of the process, its location, changes in the cavity and in a number of surrounding tissues. CT allows and reveal the tumors of Apandix and the whole intestine.
• Laparoscopy is also carried out to diagnose. With the help of an endoscope through a small incision on the abdominal wall, the location of pain is investigated and all pathological changes are determined.

During the examination of the patient, it is necessary to eliminate chronic cholecystitis, ulcerative disease, kidney disease, glides invasion, in women gynecological diseases. There are another number of rare diseases similar in the signs of the chronic form of appendicitis.

Principles of treatment of chronic appendicitis

The treatment of chronic form of appendicitis is engaged in surgeons. What treatment method will offer a doctor depends on how the sluggish inflammation is manifested. If there are no sharp attacks of the disease, and the symptoms do not deliver strong discomfort, then the patient can offer conservative therapy. It includes the reception of spasmolitics with pronounced pains, the use of antibacterial and anti-inflammatory course. A diet plays a certain meaning in the absence of strong pains and digesions. It is not recommended to get involved in coarse, seriously digestible food. It is necessary to use vegetable products and food with fiber, which warns the occurrence of constipation.

In the acute manifestation of chronic appendicitis, the surgical operation is appointed - appendectomy, which is carried out in an emergency. In a planned manner, the inflamed appendix outside the exacerbation can be removed after the normalization of blood indicators, the temperature drops and against the background of the patient's normal well-being. It is believed that the operation is especially necessary if the scars are discovered in the authority. In women with a chronic form of appendicitis and waiting for the baby, appendectomy should be carried out in the first trimester of pregnancy. The operation excludes the development of a possible exacerbation of appendicitis in the last months of pregnancy, when surgery can lead to negative consequences for the mother itself and for the fetus.

Appendectomy is currently being carried out in the traditional way and with endoscopic laparoscopy. The last type of intervention is minimally invasive, after it the patient is restored faster, and the number of possible complications is minimized.

The disease is diagnosed in young people aged 20 to 40 years. The patient is worried about recurrent bouts of pain, which cause significant discomfort. With a rescue pain syndrome, appendectomy is carried out.

Causes

Chronic appendicitis, in contrast to an acute form, is rare. Causes of its appearance:

• previously transferred acute attack of appendix, which ended without holding appendectomy;
• failure in the work of the immune system;
• hereditary predisposition;
• pathology of the circulatory system;
• endocrine diseases;
• diseases of the gastrointestinal tract, as a result of which there is a blockage of the process of stones;
• hormonal disorders;
• inflammation of appendages (in women);
• the consequence of operational intervention (if after surgery, appendix proceeds more than 2 cm was left).

The disease is more often found among representatives of weak gender. In children and the elderly children, the disease is diagnosed extremely rarely.

The predisposing factors are stress, hypothermia, improper nutrition, excess weight, bad habits and chronic.

Forms

There are 3 forms of chronic appendicitis:

• Residual (residual). The disease is a consequence of acute appendix.
• Recurrent. Manifests periods of remission and exacerbation. Over time, extensive inflammation arises, which leads to the development of complications and the need for surgical intervention.
• Primary-chronic. Another name is an unprecedented appendicitis. His appearance is not associated with the attack of acute appendix.

Symptoms

For chronic shape, a characteristic constant sluggirl inflammatory process, which leads to a change in the structure of the process. The symptoms of blurred, so on the basis of the patient's complaints, it is impossible to put an accurate diagnosis.

Chronic appendicitis is similar in symptoms with pyelonephritis, pancreatitis, cholecystitis, as well as a pressing disease of a 12-rosewoman.

Among women

Symptoms of chronic appendicitis in women:

• feeling of discomfort and gravity;
• nighting stupid pain on the right at the bottom of the abdomen, which appears after physical exertion;
• digestion disorder (constipation, diarrhea, bloating);
• cutting in the stomach, like when;
• pain when inspecting the gynecological chair.

In exacerbation, nausea and vomiting occurs, the body temperature may increase. Signs of chronic appendicitis in women during remission - lack of appetite, insomnia, deterioration in the mood, periodic pain at the bottom of the abdomen on the right.

Chronic appendicitis in women can be confused with female diseases, since the urinary system borders with a digestive tract.

In men

The symptoms of appendicitis in men differ slightly from female:

• permanent pain in the right iliac zone;
• nausea and vomiting during the exacerbation period;
• increase body temperature.

Since the appendicitis appendix in men, a week passes to their disappearance.

What doctor treats chronic appendicitis?

If the disease is in the remission stage, it is necessary to visit the district therapist or the gastroenterologist. When aggravating appendicitis, you need to contact the surgeon. Women should consult a gynecologist, to make ultrasound organs of the genitourinary system.

Sometimes the help of a proctologist and a urologist to eliminate other pathologies.

Diagnostics

The primary examination lies in the palpation of the abdomen. The pain during pressing is intensified at the bottom at the bottom right.

The patient should pass the blood test and urine. When appendicitis in plasma, moderate leukocytosis is detected.

To exclude other diseases, the patient assign instrumental techniques of the survey. Methods for the diagnosis of chronic appendicitis:

• radiography of the stomach and peritoneum using a contrast agent;
• Ultrasound organs of the abdominal cavity and the urogenital system;
• fibrogastroduodenoscopy.

Laparoscopy may be required to clarify the diagnosis.

Treatment

More often the patient is treated for treatment with the exacerbation of the chronic form of appendix. In this case, it is deleted. The operation passes under general anesthesia. The inflamed appendix is \u200b\u200bremoved using endoscopic laparoscopy. This is a minimally invasive technique, due to which the rehabilitation period is faster and easier. The patient is discharged from the hospital on the second day.

For pregnant appendectomy is carried out only in the first trimester.

With the exacerbation of the appendix, you need to call an ambulance and comply with the bed mode before it arrives. Take painkillers do not stand.

After the transferred operation, it is necessary to comply with the recommendations of the doctor:

• stick to a diet;
• perform therapeutic gymnastics to avoid complications after the operation;
• take preparations for strengthening immunity, as well as antibiotics of a group of cephalosporins or macrolides;
• to walk outside.

The course of antibacterial treatment after the operation is 7-10 days.

In the absence of sharp attacks, conservative treatment of chronic appendicitis is allowed. It includes:

• Medical therapy. The patient must take antibacterial, anti-inflammatory, antispasmodic agents, as well as drugs for improving blood circulation, vitamins and immunocormers.
• Diet. Power must be fractional, balance is balanced and diverse. It is necessary to abandon smoked, pickles, sharp, roasted and oily food. You can not drink coffee, strong black tea and carbonated drinks.
• Physiotherapeutic procedures.

Complications

The following implications:

• atrophic and sclerotic changes in Apandix;
• punching of Apandix with its contents in the abdominal cavity;
• the formation of scars and adhesions, which lead to the combustion of the process with neighboring bodies;
• apandicular abscess;
• gangrene;
• granulation tissue growth.

When aggravating appendicitis, you need to consult a doctor. In its break, irritation of neighboring organs occurs, the pus accumulates in the abdominal cavity and peritonitis develops, and sometimes even sepsis. This condition is dangerous for human life.

Prevention

Special preventive measures do not exist. Chronic appendicitis can be warned if you get rid of bad habits, keep a healthy lifestyle and eat right.

Chronic form of appendicitis, even if it proceeds without exacerbations, needs permanent observation. Only adhering to the recommendations of the doctor can avoid surgery and heavy complications.

Useful video about appendicitis

Such a disease as appendicitis is manifested by each fifth person in the world and requires operational surgical intervention. Is there a chronic appendicitis? A long time the existence of such a form was questioned. However, studies have shown scientists that this pathological state still happens. It drops 1% of all cases of illness, to a greater extent, it is diagnosed in women in young age. This article will consider the causes and symptoms, methods of treatment and prevention.

What is chronic appendicitis and how to determine it? In the language of medicine, this form of the disease is a sluggish inflammatory process in a worm-like process, which is in a blind intestine. The reason for this course of the disease is often an attack of an acute appendicitis transferred earlier.

The chronic state clinic is manifested in the following:

• the discomfort;
• pulling pain on the right, increasing after physical exertion;
• nausea;
• diarrhea or confusion;
• vaginal symptoms.

Doctors identify the following forms of chronic appendicitis:

1. Primary-chronic. Initially manifests itself in a low-rise inflammatory process, which does not switch to acute state. The diagnosis is established only after laboratory studies and methods in which other pathologies are excluded.

2. Secondary chronic. It occurs only in those patients who suffered an attack of acute appendicitis, but due to different circumstances there was a relapse. Often the reason for such a form of the disease is not enough professional medical care, after which the process has undergone an adhesive process.

In medical practice there is a classifier for women. It is divided into three types:

1. The residual course of the disease arising after a strict attack and eliminated surgical surgery.

2. Recurney. It has the same signs as an acute form - high temperature, intense pain in the right region of peritoneum.

3. The sluggish flow that practically does not have symptoms of appendicitis, that is, there is no discomfort. In this regard, it is very difficult to diagnose it.

Determine the disease is independently difficult, so medical specialists strongly recommend at the first signs of chronic appendicitis to contact the doctor. A sharp form requires surgery, in connection with this, when symptoms immediately, immediately call for medical care.

Symptomatic picture

As mentioned above, the chronic form proceeds along with painful discomfort. In addition to pain, patients complain about interruptions in the digestive system, accompanied by nausea, constipation or diarrhea. The body temperature, in contrast to an acute attack, is most often normal, only in the evening the clock may be subfebrile.

Symptoms of chronic appendicitis in women are manifested in this way:

• unpleasant sensations when urination;
• pain during examination of the gynecologist;
• constipation;
• vomiting reflex;
• frequent urge to the toilet;
• at night, the body temperature may increase;
• when palpation, the process is felt as compacted.

The attacks most often worried a woman in later or earlier the time of day. The above signs are observed in diseases of the gastrointestinal tract. Therefore, the doctor under the formulation of the diagnosis will be to identify the symptoms of appendicitis among diseases with similar factors. These include cholecystitis, ulcers, gynecological disorders and others.

Medical measures

At the moment, uniform treatment for the chronic form of appendicitis does not exist. Therefore, most often the doctors are proposed to remove the proof by surgical path. A similar method is resorted if the patient has pronounced spikes and scars in the field of Apandix. When diagnosing a woman's symptoms in a pregnancy, the process is excised only on the first trimester. It is not advised to treat at later deadlines.

The sparing method of operational intervention, both in pregnant women and other patients - laparoscopy. Such a minimally invasive method allows surgeons to see a complete picture of the disease and delete. There are cases in which open ependectomy is required. Cure the disease is per 95%, the death is only 0.05%, after surgery.

After the operation was successfully implemented, the patient assign the course of antibiotics. This is necessary due to the fact that, in contrast to the acute attack of the disease, after the treatment of chronic appendicitis, women have a high percentage of adhesions.

In cases where the patient has symptoms expressed, conservative treatment methods are used. For instance:

• reception of drugs with antispasmodic effect;
• physiotics;
• diet;
• treatment of gastroy disease.

Minor changes in the field of appendix during chronic flow are so lowered that its diagnosis is possible by morphologically by removal. But if after studying the process, it turned out to be in a normal form, that is, the high probability that appendectomy can lead to aggravation of pain. In this regard, before surgical intervention, it is necessary to conduct a thorough examination of qualified doctors. Only such an approach will help to make a diagnosis and appoint the correct treatment of appendicitis.

Preventive methods

Consider the acute form of the disease can several factors:

• blocking holes between the process and the colon;
• infection;
• irregular diet;
• constipation.

Ignoring symptoms or surgery done by an inexperienced doctor may cause chronic course of the disease. Replacing the treatment on folk remedies in which the patient does not want to attend the doctor, strictly prohibited! Otherwise, a fatal outcome is possible.

Preventive treatment of chronic illness consists in the following measures:

1. Healthy lifestyle and personal hygiene. The acute attack of appendicitis can cause infection with abdominal typhoid, intestinal tuberculosis.

2. To treat intestinal disorders in time, namely constipation. It is caused by the fact that the blocking of the hole most often happens due to the confusion. To get rid of a delicate problem, you need to eat correctly and regularly perform physical exertion.

3. Seeds with sovereign and grapes with bones are the cause of the acute attack of appendicitis.

4. The gymnastics in the morning hours helps not only feel cheerful throughout the day, but also wakes up the intestine after sleep.

The basis for the prevention of the disease is the right diet - this will confirm any physician, surgeon or nutritionist.

Dietary food must contain food rich in natural fiber, cereal from cereals, rippy, kefir, homemade yogurts. Such an approach allows to improve the process of digestion, which is responsible for the normal chair and the correct metabolism.

Based on the foregoing, it can be argued - chronic appendicitis exists. In the event that the patient has been found in the patient, it is necessary to apply for consultation to the doctor. Self-medication can not only aggravate the problem, but also lead to death. Upon the occurrence of the acute phase of the patient's disease, it should be put in a horizontal position, and better in the pose of "embryos", to ensure peace and cause an ambulance brigade.

- The sluggish form of the inflammatory process in the Cell-shaped outcoss of the blind intestine, most often associated with the previously transferred attack of acute appendicitis. The clinical picture of chronic appendicitis is characterized by discomfort, buttering pains in the iliac region on the right, increasing in physical voltage; nausea, flatulence, diarrhea or constipation, urohy, vaginal or rectal symptoms. The diagnosis of chronic appendicitis is based on the exclusion of other possible causes of this symptomatomy and may include learning anamnesis, conducting overview radiography, irrigoscopy, colonoscopy, ultrasound and other differential diagnostic studies of the abdominal organs. Treatment of chronic appendicitis with unfinished manifestations - conservative, with a rescue pain syndrome, appendectomy is shown.

General

Chronic appendicitis, in contrast to its acute form, a disease rarely found in gastroenterology. In chronic appendicitis, atrophic and sclerotic changes in appendix, the growth of granulation tissue, scars and spikes, leading to obliteration and deformation of the process, can develop atrophic and sclerotic changes.

Causes

There are three forms of chronic appendicitis: residual, recurrent and primary chronic. The residual (residual) form of chronic appendicitis is characterized by the presence of a patient's presence in the history of one acute attack, which ended with recovery without surgery. In chronic recurrent form, repeated seizures of acute appendicitis with minimal clinical manifestations in the remission stage are noted. A number of authors also distinguishes the primary-chronic (nefless) appendicitis, developing gradually, without the acute attack, without preceding him.

The residual (residual) form of chronic appendicitis is a consequence of an previously postponed attack of acute appendicitis, which stopped without surgical removal of the process. At the same time, after an element of acute manifestations in a blind intestine, the conditions for maintaining the inflammatory process are preserved: Spikes, cysts, beaters of appendix, hyperplasia of lymphoid tissue, impede its emptying.

The circulatory disorder in an affected blind process contributes to a decrease in the local immunity of the mucous membrane and the activation of pathogenic microflora. The recurrence of appendicitis is possible, both in the absence of its surgical treatment and after subtotal appendectomy when leaving the process with a length of 2 cm.

Symptoms of chronic appendicitis

The clinical picture of chronic appendicitis is characterized by the predominance of implicitly pronounced, lubricated symptoms. Chronic appendicitis is manifested by a feeling of discomfort and severity, stupid-mixing pains in the right iliac region, permanent or occurring episodically, after exercise and errors in the diet. Patients with chronic appendicitis can complain about digestive disorders: nausea, flatulence, constipation or diarrhea. The temperature is more often normal, sometimes in the evenings rises to subfebrile.

With chronic appendicitis, other symptoms can be observed: the urinary (painful and frequent urination), vaginal (pain during gynecological examination), rectal (pain in rectal research). Repeated attacks of acute inflammation of the blind process are manifested by symptoms of acute appendicitis.

Diagnostics

The diagnosis of chronic appendicitis causes difficulties in connection with the lack of objective clinical symptoms of the disease. It is easiest to diagnose chronic recurrent appendicitis, while the history of the anamnesis is very important (the presence of several acute attacks). During the next acute attack, the diagnosis of acute appendicitis is made, and not the aggravation of chronic.

The indirect signs of chronic appendicitis at palpation of the abdomen can be local pain in the right iliac region, often positive symptom of exemplary, sometimes positive symptoms of roving, Sitkovsky.

For the diagnosis of chronic appendicitis, X-ray irrigoscopy is performed by X-ray irrigoscopy, which allows to identify the absence or partial filling of the barium of the blind process and the slowdown in its emptying, which indicates the change in the form of appendix, deformation, the narrowing of its lumen. Conducting colonoscopy helps to reject the presence of neoplasms in a blind and colon, and overview radiography and ultrasound - in the abdominal cavity. Clinical blood tests and urine patient with chronic appendicitis, as a rule, without pronounced changes.

With primary chronic appendicitis, the diagnosis is made by the method of excluding other possible diseases of the abdominal cavity, giving similar symptoms. It is necessary to carry out a differential diagnosis of chronic appendicitis with a gastric ulcer, crown disease, irritable intestinal syndrome,

In the postoperative period, antibiotic therapy is necessarily carried out. Remote results after the operational treatment of chronic appendicitis are somewhat worse than after acute appendicitis, since the development of the adhesive process is noted.

If a patient with chronic appendicitis is noted non-expressed symptoms, conservative treatment is used - the reception of antispasmodic drugs, physiotherapeutic procedures, elimination of intestinal disorders.

Macroscopic changes in appendix during chronic appendicitis can be so unbearable that it is possible to identify them only with a morphological study of the remote process. If the blind process turned out to be unchanged, there is a possibility that surgery can even more exacerbate the existing pain syndrome, which served as the basis for appendectomy.