Pathology represents one of the stages of inflammation of the Appendix (vermiform Appendix), for which the typical development of a purulent process. Destructive changes (decay of the tissues of the intestine) is missing at this stage.
What is phlegmonous appendicitis?
Acute appendicitis during this period is characterized by almost instantaneous – within a few hours the formation of inflammation, accompanied by purulent fusion of the walls of the Appendix. But its integrity is maintained until the next stage of acute appendicitis. Confirm abscess form of pathology only at the time of surgery.
Phlegmonous appendicitis may be triggered by the following factors:
- Occurred blockage of the lumen of the vermiform Appendix caused by frequent spasms or foreign bodies that have penetrated into it from the intestines.
- Infection of the inflamed wall of the Appendix pathogens.
- The formation of the thrombosis of the Appendix.
Basically phlegmonous appendicitis occurs because of obstruction.
Cause it can:
- particles of the shell seeds, seeds from berries;
- small foreign objects.
Signs of the disease
To confirm the preliminary diagnosis, the doctor can only when doing the surgery to remove the abscess of the Appendix.
There are a few signs of confirmation:
- 1. Thickening, friability and edema of the walls of the Appendix.
- 2. The presence of the fibrinous layers.
- 3. Signs of purulent content.
- 4. The apparent voltage of the Appendix diagnosed at feeling.
- 5. Behind the right iliac region in the process of respiration (determined visually)
- 6. When probing during the inspection felt protective muscle tension, defined in the front wall of the peritoneum.
Signs of this stage of inflammation appear after about 6 to 24 hours from the beginning of the pathological process. The symptoms typical of catarrhal (simple) form, only amplified.
The symptoms are as follows:
- strengthening of pain;
- not a passing feeling of nausea;
- dry mouth;
- the increase in total body temperature up to high levels (more than 38°);
- raising sweat;
- strong weakness.
Additionally, the peritoneal symptoms appear:
- the tension of the muscular frame of the anterior abdominal wall;
- the lag right iliac region in the respiration process.
Acute phlegmonous appendicitis, accompanied by a significant increase in the total number of white blood cells up to 18 000-20 000 per ml.
Diagnosis phlegmonous form based on the patient’s complaints and visual inspection. Additionally necessarily performed a laboratory study of the blood.
To confirm the diagnosis can be assigned:
- Ultrasound study. The procedure eliminates the inflammation of the gallbladder and the attack of acute cholecystitis.
- The abdominal radiograph is necessary in order to distinguish an attack of phlegmonous appendicitis, from perforation (breakthrough) ulcer of stomach and duodenum.
Despite the relatively specific symptoms of acute abscess, the Appendix can be regarded as a different disease:
- 1. the deviation of the process up can be regarded as an attack of cholecystitis;
- 2. rejected down the Appendix causes States resembling acute form of diseases of the female reproductive system;
- 3. when the deviation of the inflamed vermiform Appendix back symptoms of the condition may resemble the development of right-sided renal colic.
That is why self-therapy if you suspect a developing phlegmonous appendicitis completely unacceptable. If the doubt the person is delivered to hospital, where under observation and, if necessary, is performed and surgical treatment.
Possible complications and consequences
The phlegmonous form is a serious threat not only to health but also human life in General. The absence of adequate therapy will provoke such complications and consequences are:
- 1. acute inflammation of the Appendix, accompanied by rotting of the tissues of the gut (destructive appendicitis);
- 2. breakthrough of the Appendix;
- 3. the formation of peritonitis;
- 4. appendicular infiltrate (commissural education, including the Appendix and the loop of the blind and the small intestine, omentum);
- 5. appendicular abscess (limited purulent inflammation spread to the tissues of the peritoneum);
- 6. the development of sepsis followed by septic shock.
But complications can pertain to other organs. Abscess untreated appendicitis can cause such consequences, as suppuration, and further thrombosis of the hepatic veins.
Treatment of phlegmonous form of inflammation
Therapy abscess of the variety of pathology is possible only one way – removal of the inflamed Appendix. And the faster the operation will be made, the lower the likelihood of complications. The postoperative period is easier.
Appendectomy is possible in several ways:
- 1. Open intracavitary. Here is performed an incision and removed the Appendix. The duration is approximately 40 minutes, but in the absence of any complications.
- 2. Treatment by laparoscopy is allowed only in the initial stage of development phlegmonous form.
- 3. Transluminalna. A brand new technique allowing to remove the inflamed element by means of thin tools introduced into the body through the stomach.
Time surgery eliminates any negative consequences.
The first postoperative week
Regardless of which technique was used in the treatment, compliance with gentle treatment of living will be needed throughout the next month.
Especially the first week:
- 1. Patients who underwent classic operation, allowed to stand a few hours later. The key criterion is the restoration of coordination of movements after the completion of the anesthesia. As a rule, in the evening, he can climb up to visit the restrooms accompanied by staff.
- 2. When before the complications start up is only allowed on the following day, but movements are limited to not be.
- 3. Classes on breathing exercises and exercise therapy is indicated in all patients.
- 4. Food should be dietary and help restore proper bowel function.
- 5. Definitely recommended to wear a brace to support the wound.
- 6. Daily dressings. The wound area should be treated with antiseptic solutions.
- 7. Outer sutures are removed 7-8 days.
For the next three postoperative months, you will need to eliminate any heavy physical work.
The diet after surgery should be maintained during the first two weeks:
- 1. You need to completely withdraw from the daily diet of any marinades, fried, spicy and greasy meals and foods, carbonated drinks, strong coffee and tea, fresh bread.
- 2. Served food should have mashed potatoes or mushy consistency. As a method of cooking diet allows the use of boiling, roasting and stewing for a couple.
- 3. Recommended diet foods, in particular lean meats, “skinny” soups, well boiled porridge, steam cutlets and meatballs, jelly.
Diet after the removal of the Appendix during the first postoperative days should be very strict.
- Any dense consistency of food is strictly prohibited.
- Power fractional, and only in small portions.
- Allowed yogurt, pudding, “skinny” soup, liquid mashed potatoes.
On the second day – in the absence of complications the diet can be expanded. “Resolution” at full power in accordance with the diet is the first chair. By the usual diet of man returns a month later after the operation on the Appendix.
The prognosis for timely treatment to the doctor and obtaining qualified help is always favorable.