the Appendix - cherveobraznyj a shoot of a blind gut which is located practically on border between thin and thick kishechnikom.

Cherveobraznyj the shoot is available for many rodents, some predators, monkeys and, certainly, at the person. The length of a human appendix on the average makes 5 - 15 sm, diameter - nearby 1 see Predpolozhitelno, its primary goal consists in protecting thin intestines from the bacteria occupying blind kishku.

Appenditsitom name an appendix inflammation. This disease meets extremely often and demands carrying out emergency surgical operatsii.

Appenditsit can happen at each person, irrespective of vozrasta.

Simptomy. Clinical displays of a sharp appendicitis depend on character of morphological changes in a shoot, its arrangement, age of patients, character of the joined complications. An initial symptom of disease - suddenly arising stupid pain without accurate localisation in the top half of stomach or navel area. Through А-6 ch (with fluctuations from 1 to 12) the pain moves in right podvzdoshnuju area. Change of localisation of pains with morbidity occurrence in right podvzdoshnoj specifies areas in disturbing occurrence of the somatic pains caused by irritation vistseralnoj brjushiny (i.e. The inflammation has grasped all layers of a wall of a shoot). Pain localisation depends on an arrangement cherveobraznogo a shoot: at typical position of its patient feels a pain in right podvzdoshnoj areas, at high position - almost in right podrebere, at retrotsekalnom position - on a lateral surface of a stomach or in lumbar area, at tazovom position - over lobkom. The nausea - a frequent symptom of a sharp appendicitis, sometimes, especially in the disease beginning, is possible vomiting. The chair in most cases is not broken. At a shoot arrangement near to blind or a rectum or among loops of a thin gut the inflammation can extend on an intestinal wall that leads to a liquid congestion in a gleam of a gut and ponosu.

Jazyk in the disease beginning damp, often is imposed white the sung. A manumission lays on a back or the right to a side; change of position of a body, cough, laughter, a sneezing sharply strengthen a pain in a stomach. At stomach survey backlog right bottom kvadranta a belly wall can be marked at breath. At palpatsii find out pressure of muscles and sharp morbidity in right podvzdoshnoj areas. Here positive symptoms of irritation brjushiny (symptom SHCHetkina - Bljumberga, Razdolsky, Voskresensky) can be defined. Patognomonichnyh symptoms of a sharp appendicitis are not present, all semiology is caused by the phenomena of a local peritonitis the Pain, as a rule, amplifies at position of the patient on left to a side (a symptom Sitkovsky), especially at palpatsii (symptom Bartome - Mihelsona). At retrotsekalnom a shoot arrangement the positive symptom morbidity-strengthening can be exemplary at podnimanii the straightened right foot. This symptom should be checked up very cautiously as at rough pressure upon a belly wall shoot punching is possible. The temperature is raised often to subfebrilnyh figures. In blood-lejkotsitoz with formula shift to the left. At manual research of a rectum or vlagalishchnom research morbidity is marked at palpatsii the right wall of a basin (especially at tazovom shoot position). Presence eritrotsitov and leukocytes in urine does not exclude sharp appenditsita.

Diagnoz a sharp appendicitis in typical cases is simple, however atipichnost arrangements and features of a current of inflammatory process sometimes extremely complicate disease diagnostics. The differential diagnosis spend with pielitom, nephritic kolikoj (Urolithic illness), sharp adneksitom, extra-uterine pregnancy, a sharp enteritis, mezadenitom, divertikulitom, a sharp cholecystitis, a sharp pancreatitis, probodnoj a stomach ulcer see and a duodenal gut, the right-hand pneumonia, surrounding it is deprived also other Razlichajut a sharp simple and destructive appendicitis. In the latter case the semiology of a sharp appendicitis is more expressed: more strongly a pain, irritation symptoms brjushiny, above lejkotsitoz and temperature are more accurate. However full conformity of a clinical picture of disease to character of revealed morphological changes in a shoot nevertheless not nabljudaetsja.

Techenie a sharp appendicitis at children, old men and pregnant women has the features. At children nedorazvitie the big epiploon and giperergicheskaja organism reaction lead to fast progressing of inflammatory process and peritonitis development. Diagnostics of a sharp appendicitis at children in an initial stage of disease is difficult: a nausea, repeated vomiting, a heat, the poured pain in a stomach in this connection diagnostic errors are quite often committed. At old men decrease in reactance of an organism causes stertost clinical symptoms of disease that can be an occasion to overdue diagnostics and hospitalisation. From here the prevalence of destructive forms of a sharp appendicitis and is frequent - appendikuljarnyh infiltratov. At pregnant women displacement of a dome of a blind gut and cherveobraznogo a shoot a uterus leads to change of typical localisation of pains, and a shoot arrangement behind a uterus - to expressiveness decrease peritonealnyh simptomov.

appendicitis Treatment

Lechenie operative. Operation is shown not only in each clear case from the diagnostic point of view, but also at the proved suspicion on a sharp appendicitis, at impossibility on the basis of clinical signs and special methods of research (including a laparoscopy) to exclude a sharp inflammation of a shoot. At the expressed signs of a peritonitis expediently even before operation to enter antibiotics (aminoglikozidy) and metronidazole. At thin patients of young age appendektomiju, as a rule, spend under local anaesthesia of 0,25-0,5 % by a solution novokaina. At the expressed painful syndrome at patients with unstable mentality, children, pregnant, sick elderly and senile age should prefer the general obezbolivaniju.