Appendicitis: symptoms and treatment in adult men, effective methods

The cecum is the initial section of the large intestine, covered on all sides by the peritoneum and located in the fossa that is formed by the right ilium. In the cecum, the residual mass of the undigested food lump begins to move and water is absorbed, and excrement is formed. The appendage of the cecum, which has a slightly curved shape, is called the appendix or appendix. When the appendix becomes inflamed, the patient is diagnosed with appendicitis. Appendicitis is an emergency surgical pathology, and surgery to remove the inflamed intestinal appendage occupy a leading position among all surgical interventions on the abdominal organs cavity.

Inflammation of the appendix has peculiar signs that are difficult to differentiate with manifestations of other diseases without the use of special techniques and methods of hardware diagnostics. As a result of the inflammatory process, acute thrombosis of the artery that feeds the appendix tissue occurs, which leads to the rapid death of organ cells. If a person does not seek medical help in a timely manner, a rupture of the appendix and the release of purulent contents with intestinal bacteria and their waste products may occur. In most cases, this pathology ends with sepsis and peritonitis, so it is important to know the signs of the disease. This is especially true for men, since the symptoms of appendicitis in adult men may differ slightly from the clinical picture of inflammation in women.

Why can a man get appendicitis?

The prevalence of the disease among men aged 20-55 is about 4.4%. The main cause of the inflammatory process today is considered to be the blockage of the lumen of the vermiform appendage with feces, calculi, foreign bodies, but experts do not exclude other factors that can also cause the activation of the pathogenic flora of the intestine and the onset appendicitis. Infectious disease doctors believe that a provoking factor in men leading an asocial lifestyle or living in unfavorable social conditions, there may be infections characteristic of this group patients: tuberculosis, typhoid fever, acute intestinal infections, accompanied by erythema nodosum and allergic reactions of a toxic type.

Obturation (blockage) of the lumen of the appendix can occur as a result of the penetration of various worms and other parasites into it. This situation is typical for chronic helminthiasis in the absence of adequate and timely therapy. If the cause of appendicitis is infection with worms, a few days before the attack (less often - several weeks), a man may feel increased weakness, drowsiness. He may have cramping pains in the lower abdomen, rumbling in the intestines, anal itching, vomiting, and nausea.

Other factors that can provoke circulatory disorders in the appendix and the development of the inflammatory process, experts include:

• ingestion of foreign bodies (fish and chicken bones, grape seeds, seed husks) into the gastrointestinal tract;
• blockage of the lumen of the appendix with fecal stones in chronic constipation of the spastic or atonic type;
• chronic bowel disease (colitis, irritable bowel syndrome);
• pathologies of the abdominal organs, in which it is possible to form areas with scar tissue, bending or squeezing the arteries of the appendix (chronic pancreatitis, cholecystitis, adhesive disease).

In men with systemic diseases of the veins and blood vessels, the risk of developing acute appendicitis is 3-4 times higher than in men without vasculitis or arteritis.

Note! Increased secretion of serotonin by cells of the appendage may also be one of the factors provoking appendicitis, since this hormone is a mediator of inflammation. Large amounts of serotonin can be produced with increased consumption of chocolate and foods containing cocoa butter or cocoa beans.

The first signs of inflammation in men: the clinical picture at the beginning of the attack

It is not always possible to recognize the signs of appendicitis in adult men on the first day, although they appear within 24 hours of the onset of inflammation. This is due to the fact that at the catarrhal stage (from the word "catarrh" - inflammation of the mucous membranes), the process has superficial course, so many of the symptoms characteristic of appendicitis may be mild or be absent altogether.

Pain at the onset of inflammation

Pain syndrome resulting from inflammation of the nerve endings of the appendix is ​​the main clinical sign of the inflammatory process in the tissues of the organ. Moderate pain, as a rule, occurs in the central part of the epigastric space - the upper abdomen. They can be dull, dagger-shaped, or spastic, less often patients describe pain as a sharp or cutting sensation. The displacement of the pain syndrome to the region of the right iliac fossa occurs 4-12 hours after the first signs of appendicitis appear.

In rare cases, pain appears immediately in the lower abdomen on the right. Irradiation to other zones for appendicitis is uncommon, although in medical practice there are also atypical cases of this pathology, when painful sensations arise in the lower back, buttock and on the inner surface of the thigh.

Body temperature

An increase in temperature with a lesion of the appendix occurs sharply, but the thermometer almost never exceeds the upper limit of subfebrile condition (for adults it is 38 ° C). The hallmark symptom of appendicitis is the short duration of the fever: in most cases, fever normalizes or decreases to 37 ° С by the beginning of the second day, in rare cases it can keep within 37.5-38 ° С during 48 hours.

Important! A longer course of subfebrile fever may indicate that perforation of necrotic tissue (perforated appendicitis) has occurred. High temperature in this case occurs as a result of the imposition of leukocytes, erythrocytes on the edges of the rupture and fibrin - a non-globular protein synthesized by liver cells under the action of certain enzymes blood.

Can there be vomiting with appendicitis?

Vomiting with any form of appendicitis is almost never repeated. A typical clinical picture for adult men is a single or double discharge of vomit. Vomiting is of a reflex nature, the emitted masses have a normal color, do not contain any admixture of bile components and undigested lumps of food. If vomiting is repeated more than 2 times, it is accompanied by cramping abdominal pain, fever, it is necessary to exclude enteritis - inflammation of the intestinal walls with dystrophic changes in the mucous and submucous layer.

Note! Against the background of the inflammatory process, a man often has nausea, appetite disappears, and a decrease in body weight is possible. The listed signs always appear after the pain syndrome. If signs of intoxication occur before pain occurs, the cause is most likely gastroenteritis (inflammation of the gastrointestinal tract).

Signs of pathology on the third day of inflammation

On the third day of appendicitis, the intensity of painful sensations becomes very high, the patient's mobility is sharply limited. A man often lies, tries to take the "fetal position", in which the pain is not felt so acutely (lying on the right side, legs bent at the knees and pulled up to the stomach). Unpleasant sensations intensify with a change in body position, physical activity. With phlegmonous or gangrenous appendicitis, the pain may also become more intense when going to the toilet, coughing, or any other activity that requires tension in the abdominal muscles.

Nausea and poor appetite on the third day of inflammation persist, many men completely refuse food and drastically reduce their fluid intake. Other symptoms common to appendicitis in men include:

• upset stool (mainly diarrhea, constipation with appendicitis is noted in only 3% of men);
• increased blood pressure;
• moderate tachycardia (can be pronounced if the patient is at risk for the development of cardiovascular pathologies).

In some men, symptoms of an attack may occur from the genitourinary system. This is due to the anatomical features of the structure and location of the intestinal appendage. If the appendix is ​​severely inflamed, it can irritate the walls of the bladder, causing frequent urge to urinate. pain during emptying of the bladder, feeling of pressure and fullness in the lower abdomen in the small pelvis.

If the pain is gone

This can happen 5-7 days after the onset of inflammation. This is the most unfavorable form of appendicitis, in which there is a complete death of the cells of the appendage - necrosis. Necrotic tissue is most susceptible to perforation, so it is important not to delay the visit to the hospital. The reason for the weakening or disappearance of the pain syndrome is the death of nerve endings, which cease to respond to the inflammatory process. If at this stage the appendix ruptures, purulent exudate will fill the peritoneal cavity. In most cases, there is no more than 12 hours to provide emergency care and save the patient's life, therefore in case of sudden disappearance of pain lasting more than 1-2 days, you must immediately contact a medical institution.

Can it hurt on the left side?

Irradiation of pain to the left side of the trunk is not typical for all types of appendicitis, however, some men with severe and advanced forms of inflammation describe the pain syndrome as diffuse or encircling sensations of high intensity. Left side pain can also occur in men with organ transposition - This is a rare variant of biologically normal body anatomy, in which the internal organs are located on the opposite side in relation to the physiological norm (mirror symmetry of organs).

Clinical Tests for Diagnosing Peritoneal Irritation

It is quite difficult to carry out them at home without possessing special skills, therefore it is better to entrust the examination to a specialist. Inappropriate actions can harm the patient's health and exacerbate existing symptoms, including pain.

Table. How the various clinical tests are performed.

Symptom name	How is the diagnosis performed?
Britten's symptom	Muscle tension is noted during palpation of areas with maximum pain. When pressed, the right testicle is pulled up to the scrotum, after the cessation of palpation, it drops to its original position.
Dolinov's symptom	If a man is asked to suck in his stomach, the pain will intensify.
Krymov's symptom	Palpation of the external opening of the inguinal canal is carried out on the right side, during which pain appears from the area of ​​the right iliac fossa or intensifies.
Payr's symptom	During bowel movements, tension and spasticity of the anal sphincter muscles occur.

During a classical examination in the supine position, an increased tension of the muscles of the abdominal wall is revealed. If you ask a man to jump or walk, the painful sensations will intensify. During rectal palpation of the ampulla of the anterior rectal wall, maximum pain occurs, which can be considered a direct indication for surgical intervention.

Purulent form of inflammation: can you recognize it yourself?

Despite the fact that it is completely impossible to diagnose appendicitis at home, there are signs, the occurrence of which indicates the need for emergency surgical interference. They can be considered as manifestations of purulent appendicitis in men only in conjunction with the main symptom complex (abdominal pain, nausea and vomiting, fever on the first day inflammation). Dangerous symptoms that occur about the third to fifth day after the first signs appear include:

• disturbances in the work of the nervous system (irritability, anxiety, confusion);
• severe tachycardia (in some men, the heart rate increases to 110-130 beats per minute);
• sticky sweat on the forehead and palms;
• a grayish coating on the surface of the tongue;
• severe bloating;
• intestinal cramps;
• pallor of the skin and mucous membranes.

If at this stage the patient is not provided with the necessary surgical care, the risk of death will be more than 65%.

How is appendicitis treated?

The only way to effectively treat appendicitis and its complications is through surgery (appendectomy). Modern methods of surgical treatment make it possible to carry out operations even during pregnancy, although certain risks in pregnant women are present, especially if the intervention is performed in the first or third trimester pregnancy.

After appendectomy, the patient is prescribed a sparing diet, antibiotics to prevent secondary infection ("Amoxicillin", "Augmentin"), broad-spectrum antimicrobial drugs ("Metronidazole"), drugs for prevention thrombosis. If the cause of inflammation is obturation with helminths, it is necessary to take antiparasitic agents ("Vermox", "Nystatin", "Levamisole").

In the absence of complications, timely seeking help and following all the doctor's recommendations, full recovery occurs 2-3 weeks after the operation.

Video - Symptoms of appendicitis in adults