Acute appendicitis mkb 10

Acute appendicitis is characterized by open inflammation of the appendix. Regardless of age, 1 in 200 people worldwide get acute appendicitis.

Most often, people from 20 to 40 years old are susceptible to this disease, more often the disease occurs in women than in men.

In the International Classification of Diseases (ICD), acute appendicitis is under the ICD number 10.

Causes of the disease

The problem does not arise for only one reason, there is also no specific microbe that contributes to the development of the disease:

• The presence of a foreign body near the worm-like segment damages the mucous membrane.
• The feces stagnate in the appendix.
• In the presence of morphological prerequisites, such as a hypertrophic reaction of lymphoid tissue.

Classification

It is accepted to classify into:

• Catarrhal stage.
• Destructive stage.
• Phlegmonous stage.
• Phlegmonous-ulcerative stage.
• Gangrenous stage.
• Primary stage (manifested at the first artery thrombosis in the appendix)
• Secondary stage (It manifests itself with the natural development of suppuration in the organ)

Complications of the disease:

• The appearance of an appendicular infiltrate.
• The appearance of purulent pertonitis.
• The manifestation of abscesses in the abdominal cavity.
• The appearance of a phlegmon behind a peritoneum.
• The appearance of pylephlebitis.

With different forms of acute appendicitis, the level of the inflammatory process may be reflected.

Different stages differ from each other not only morphologically, but they also have different courses of the disease. Therefore, in an accurate diagnosis, information about the existing stage of the disease should be contained.

Complications are directly related to changes in appendicitis in inflammatory processes. But some of them can be after complications after surgery.

Symptoms of acute appendicitis

There are quite a few symptoms of the disease, let's take a closer look:

• The onset of the disease is acute.
• Always accompanied by abdominal pain.
• This disease appears suddenly.
• Appetite decreases in 95% of cases out of 100.
• In 90%, it is accompanied by nausea.
• There is rare vomiting.
• The bowel movement is normal, sometimes there may be diarrhea.
• Over time, the body temperature rises.
• Painful sensations when not on the right side.
• Symptoms accompanying peritoneal irritation are possible.
• Painful sensations appear when the pulsating hand is removed after pressing on the abdominal wall.

Mixed symptoms indicate an untimely diagnosis of the disease.

People over 60 are more susceptible to death. During pregnancy, 1 in 2,000 women in a position suffers from acute appendicitis. It is very difficult to diagnose the disease in girls in position.

The course of the disease

Different stages of the disease last in different ways. The catarrhal stage takes 6 to 12 hours. The phlegmonous stage develops after 12 hours from the onset of the disease. The gangrenous stage develops after a day, a maximum of two days.

The developing acute destructive peritonitis is the cause of severe abdominal sepsis, as well as the main cause of death.

The very first symptom of a disease is pain in the abdomen. At the first (initial) stage of the course of the disease, pain is localized in the epigastrium or the umbilical region, the pain is not intense, more often of a dull nature.

Coughing, or abruptly changing the position of the body, the pain becomes much stronger. After a couple of hours after the onset of pain, it passes into the right iliac region and is characterized by patients as: twitching, stabbing, burning, cutting, sharp and dull.

It depends on where the appendix is ​​located, pain can be given to the navel, lower back or groin.

If the patient is diagnosed with acute appendicitis, the patient's digestion is disturbed, he is nauseous, sometimes vomits, flatulence and constipation are also noted.

Typically, the temperature rises to 39 degrees over several days.

With a destructive change, the pain becomes stronger, this affects the patient's condition.

Sometimes there is a decrease in pain or even its disappearance. This is a very bad sign, which indicates the appearance of gangrene of the appendix.

Characteristics of the disease

The initial phase of the inflammatory process of the appendix is ​​called acute catarrhal appendicitis.

The process is thickened in size, with a dull serous membrane, under it you can see many filled small vessels with blood, and this gives the impression of a bright hyperemia.

When cutting the mucous membrane of the appendix, it can be seen that it is in a edematous state, gray-red in color.

Microscopically, it is possible to see small defects in the mucous membrane, they are covered with fibrin and leukocytes.

The serous membrane can contain many dilated vessels. Occasionally, a sterile, clear, and reactive effusion can be produced in the abdominal cavity.

Treatment of the acute course of the disease

At the slightest suspicion of an acute manifestation of appendicitis, it is necessary to hospitalize the patient as soon as possible in the surgical department, in the inpatient department.

Only surgical treatment is used for treatment. Contraindication to surgery is the presence of an appendicular infiltrate without signs of peritonitis.

Surgical intervention

Different clinics use different methods of open and laparoscopic appendectomy.

Open appendectomy method

During the operation, the doctor at any time must be ready to completely change the plan of the surgical intervention and carry out a much larger operation.

• Laparoscopic appendectomy is indicated for three groups of patients.
• The presence of a disease in children.
• If it is impossible to exclude the presence of the disease during dynamic observation.
• If you suspect a disease in girls and women of reproductive age.

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