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Phlegmonous appendicitis is an acute inflammatory process that affects the appendix. There is a pronounced swelling, accumulation of pus. Patients complain of intense pain in the abdominal region, on the right. Nausea, vomiting often join, body temperature rises. The diagnosis is made on the basis of complaints, in some cases, a blood test is taken and an ultrasound examination is performed. During therapy, surgery is required. With timely removal of the appendix, the prognosis for the patient is favorable.

Phlegmonous appendicitis is one of the stages of an acute inflammatory process that affects the appendix.

The development of this stage is observed a day or more after the onset of inflammation. On the surface of the appendix, fibrin films form, a purulent process joins. The risk group includes women 25-45 years old, especially pregnant women.

Why does phlegmonous appendicitis occur?

The exact reason for the development of an active inflammatory process is currently not clear. Among the predisposing factors are:

• thrombosis of the vessels of the appendix with the subsequent development of ischemia;
• the development of an inflammatory process in the walls of the appendix, which becomes more susceptible to the effects of infectious pathogens;
• activation of the intra-intestinal conditionally pathogenic microflora;
• mechanical obturation of the appendix with feces;
• parasitic invasion.

The phlegmonous form of appendicitis can also develop as a result of inflammatory enlargement of the lymph nodes, which block the lumen of the appendix and create favorable conditions for the growth and reproduction of pathogenic microflora.

Among the mechanical causes, the effect of adhesions, which are formed after surgery, as well as under the influence of chronic inflammation, is distinguished.

Clinical picture

Infectious pathogens penetrate the appendix along with blood, lymph, or from the intestines. The following stages of the inflammatory process are observed: catarrhal, phlegmonous, gangrenous. In patients with phlegmonous appendicitis, there is a thickening of the walls of the appendix, they are covered with fibrin. Pathology develops with the involvement of the adjacent peritoneal area. In severe cases, the formation of ulcerative and erosive lesions is observed.

Video: Acute, phlegmonous appendicitis: what is it?

Early signs of damage include complaints about:

• nausea;
• increased body temperature;
• intense, constant, throbbing pain localized in the right side of the abdomen;
• in childhood, pain can spread to the entire abdominal region;
• if the appendix is ​​localized atypically, then there is pain in the suprapubic area and in the groin.

Vomiting is not a characteristic symptom for the phlegmonous form of appendicitis.

At the first signs of a violation, it is important to refrain from self-medication and seek qualified medical help.

Diagnostics

It is necessary to differentiate phlegmonous appendicitis with the following pathological processes:

• ruptured ovarian cyst;
• ectopic pregnancy;
• an inflammatory process that affects the large intestine;
• renal colic;
• diverticulitis.

To confirm the diagnosis, ultrasound diagnostics of the peritoneal and pelvic organs is performed. Ultrasound confirms the inflammatory process in the appendix and excludes the progression of cholecystitis, pancreatitis, the inflammatory process that affects the fallopian tubes. If the diagnosis is difficult, computed tomography is additionally recommended.

Treatment

The main method of therapy for the phlegmonous form of the disease is surgery. An immediate appendectomy is required under general anesthesia. If there are contraindications, local anesthetic drugs are used.

Laparoscopic surgery is less traumatic: the surgeon makes several small punctures or incisions through which a tube with a small camera is inserted. The progress of the operation is monitored on the monitor screen. After laparoscopy, in the absence of complications, the patient is discharged after 24-48 hours.

After surgery, a course of antibiotic therapy is shown: intravenous infusion followed by a switch to oral pills. In the absence of complications, including peritonitis, the patient recovers quickly and returns to his usual way of life. During the rehabilitation period, it is important to follow a diet, exclude foods that provoke flatulence: dairy products, legumes, fresh baked goods with the addition of yeast, simple carbohydrates.

What complications can arise?

With untimely therapy, there is a likelihood of complications:

• local or diffuse peritonitis;
• perforation of the walls of the appendix;
• transformation of phlegmonous appendicitis into gangrenous;
• the formation of abscesses and adhesions;
• purulent blood clots;
• the formation of pylephlebitis;
• the most dangerous complication is sepsis.

With timely access to qualified medical care, the prognosis is favorable. Specific prophylaxis is not provided, it is important to start high-quality treatment in a timely manner.

Sources:

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https://medi.ru/klinicheskie-rekomendatsii/ostryj-appenditsit-u-vzroslykh_14132/