What is appendicitis?

It is the name given to the inflammation of the wormlike extension of the caecum called appendix. It can be confused with many diseases and cause serious complications.

What causes appendicitis?

It occurs when the internal cavity of the appendix is ​​blocked by microbes (Schistosoma or Strongyloides, etc.), calcium salts or fecal plugs (such as fruit seeds). For this reason, the inside of the appendix organ swells and causes edema, bacteria collect in the appendix organ due to the obstruction of lymph flow and venous circulation and spread to the peritoneum when perforated. In addition, a picture called lymphoid hyperplasia occurs as a result of swelling of the lymph nodes after infection with Crohn’s disease and amoebae.

How often does appendicitis happen?

Appendicitis occurs in about 7% of the population and in one in 1,000 people per year.

It is 1.4 times more common in men than women.

2% of all surgical interventions and approximately 50% of emergency interventions are performed for appendicitis.

It is rarely seen in infancy, it occurs very frequently in childhood and especially in adolescence. The average age of occurrence is 22.

It is observed at a lower rate in societies fed with high fiber.

What are the symptoms of appendicitis?

Loss of appetite: seen in 50% of patients.

Nausea and vomiting: seen in 60-90% of patients

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Diarrhea or vomiting: occurs in 20% of patients

Abdominal pain: It is seen in 25% of the patients and starts around the navel and settles in the lower right part of the abdomen, these symptoms have a value of 80% in the diagnosis.

In 80% of patients, symptoms have been present for 48 hours. However, in 2% of patients, the symptoms may last up to two weeks.

Some patients may have difficulty urinating and blood may come from the urine.

What diseases is appendicitis confused with?

Appendagitis (inflammation of the fatty portions hanging from the intestine)

Intestinal diverticulitis

Intestinal inflammation (gastroenteritis, Yersiniosis)

bowel cancer

Crohn’s disease

Ectopic pregnancy

Endometriosis

Stone in the urinary tract (ureter)

urinary tract inflammation

inflammatory bowel disease

Constipation

Inflammation of the female tracts (tubes and ovaries)

intra-abdominal abscess

Meckel’s diverticulum

Mesenteric lymphadenitis (inflammation of the intestinal lymph nodes)

Mesenteric ischemia (occlusion of intestinal vessels)

Omental torsion (suffocating of the fat layer on the intestines)

Abscess in the thigh muscle (Psoas)

myoma in the uterus

Bleeding in the rectus muscle (hematoma)

Gallbladder inflammation

Ovarian cyst knotting (torsion)

What are the examination findings of appendicitis?

96% of patients with acute appendicitis have tenderness in the lower right abdomen. During the examination, the patient contracts this part and feels severe pain.

Pain is felt when the lower left side of the abdomen is pressed to the right (Rovsing sign).

The patient feels pain when the right leg is bent upward (obturator sign) or bent backward (psoas sign).

What tests are performed in the presence of appendicitis?

Leukocyte: this value indicating inflammation is high in 80-85% of patients.

CRP: It is useful in the diagnosis of 95%.

Abdominal X-ray: It is useful in diagnosis at a rate of 10%.

Ultrasonography (USG): It is useful in the diagnosis of 85-95%.

Computed tomography (CT): It is useful in the diagnosis of 90-95%.

Magnetic resonance imaging (MRI): It is useful in the diagnosis of 90-95%.

What is the treatment for appendicitis?

First, food is prohibited and some antibiotics are given with serum.

Treatment of appendicitis is the removal of the appendix organ, with limited exceptions. This procedure can be done by the classical surgical method or by the laparoscopic method as it has been applied more intensively for the last 20 years. The laparoscopic method provides serious benefits in differentiating reproductive organs problems, especially in women of childbearing age. While the success rate with the classical method is 90-95%, the success rate with the laparoscopic method is 90%.

What are the complications of appendicitis?

wound infection

Opening of the wound

Intestinal knotting

Abscess development in the abdomen and pelvis (pelvis)

Inflammation in the separated appendix root

The rate of death (mortality) due to appendicitis is about 0.2-0.8%, this rate can be up to 20% in people over 70 years old.

Perforation or perforation of appendicitis (perforation, perforated appendix) is more common in people under 18 years of age and over 50 years of age.

Plastrone appendicitis

sepsis

pyephlebitis

What does plastron appendicitis mean?

After severe inflammation or perforation (perforation) of the appendix organ, the body wraps this area with fatty tissue surrounding the intestines, called the omentum, or small intestines. plastron It forms a hard mass called This mass is formed because the body tries to deal with the problem on its own. This mass is often hard palpable in the lower right part of the abdomen. Plastrone appendicitis Ultrasonography or computed tomography are often used in the diagnosis. Strong antibiotics are used in the treatment. If these patients are taken to appendicitis surgery in the early period, the possibility of intestinal perforation increases as it is difficult to distinguish between hardened inflammatory tissue and healthy intestines during the operation, and therefore, the appendix organ is surgically removed 1.5-2 months after the development of this condition, rather than in the early period in this patient group. (appendectomy surgery).

What does sepsis mean?

After the inflammation of the appendix organ, the bacteria mix into the blood and cause poisoning in the blood, which is called sepsis. In a patient with this condition, severe abdominal pain, high fever, sweating, high pulse, fainting sensation and coma are seen. In these patients: surgical removal of inflammation of the abdominal cavity, intensive antibiotic and intensive care treatment are required.

In which patients should be careful in case of appendicitis?

Children:The diagnosis of appendicitis can be difficult in children, as children often do not fully describe pain.

Seniors: constipation, rheumatic conditions, etc. with advanced age. Due to the ongoing problems, the elderly may not realize that there is an extraordinary situation in the case of appendicitis and may apply to the doctor late.

Pregnant: Appendicitis occurs in one out of every 2,000 pregnancies, often in the first 6 months of pregnancy. With the growth of the uterus from the bottom up, the appendix organ shifts upwards and to the right, so pain in pregnant women may be felt in the right middle or upper right part of the abdomen instead of the lower right part of the abdomen compared to normal. It is known that appendicitis surgery to be performed in pregnant women causes preterm birth at a rate of 10-15%, death of the baby at a rate of 3-5%, and these rates can increase up to 5 times in the presence of perforated appendicitis.

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