Classification of appendicitis: everything about acute appendicitis

Appendicitis is a nonspecific inflammation of the appendix of the cecum.

Pathology affects people regardless of age and gender, and causes serious complications.

Almost 90% of all acute surgical pathologies are associated with acute appendicitis.

The patient experiences severe pain in the abdominal cavity, the body temperature rises, nausea appears, sometimes vomiting opens, and the stool is disturbed.

There is a certain classification of appendicitis, depending on the nature of the pathology and the causes of its occurrence.

When a patient enters the hospital, the doctor carefully conducts a diagnostic study in order to establish an accurate diagnosis.

Types of appendicitis in adults

Appendicitis is classified into two categories based on the nature of the course of the disease - acute and chronic.

There are four main types of acute:

• Appendicular colic with mild clinical symptoms;
• Catarrhal appendicitis, referring to a simple form with a superficial inflammatory process;
• Destructive (these changes include perforated, phlegmonous, gangrenous appendicitis);
• Complicated course, which is characterized by the development of abscesses, appendicular infiltrates, purulent inflammatory processes in the abdominal cavity.

The nature of the course of the disease

In acute appendicitis, strong inflammatory processes develop, all the unpleasant symptoms accompanying the pathology develop rapidly.

In this condition, the patient needs urgent hospitalization and surgical intervention.

The chronic form of the disease is much less common. It is more difficult to diagnose, but it is also subject to appendectomy.

Acute form

This form of the disease manifests itself with pronounced symptoms, in which the inflammatory process develops rapidly.

Pathology is accompanied by the following symptoms:

• Painful sensations;
• Nausea, sometimes vomiting;
• Stool disorders (diarrhea or constipation);
• Bloating, flatulence;
• Increased body temperature.

With such a diagnosis, patients are strictly forbidden to apply a heating pad on their stomach, take painkillers drugs, alcoholic beverages, do cleansing enemas, take laxatives and antibacterial drugs.

The patient requires rest and bed rest.

Chronic form

Diagnosis of the chronic form of appendicitis is much less common. Making an accurate diagnosis is complicated by an unclear and vague clinical picture of the disease.

The symptoms of the disease are not bright, the pain syndrome is distorted, there are no changes in the cavity of the appendix.

The following signs are noted:

• In the chronic form of the disease, the lumen of the appendix narrows. This leads to an accumulation of gas, pus, and edematous fluid.
• The nature of the pain syndrome is insignificant.
• The pain can intensify after eating, the slightest physical exertion.
• Stool disorders in the form of diarrhea or constipation are noted.

On palpation of the abdominal cavity, the patient feels a painful effect on the right. There is a feeling of discomfort when trying to raise the right leg.

The tone of the muscle tissues of the right peritoneal region is significantly reduced. While walking, the right leg is fatigued faster than the left.

Classification of the disease by the complexity of the process

The pathological process occurring in the appendix of the cecum can develop in different ways. It is capable of gaining different momentum, covering different scales.

Depending on the complexity and depth of the inflammatory process, there are many types of acute appendicitis.

Catarrhal

The initial stage of the disease is referred to catarrhal appendicitis. It lasts for 12 hours.

Symptoms of the inflammatory process can be hidden against the background of other diseases of the abdominal cavity.

The patient complains of pain in the umbilical region, after 8 hours it shifts to the right side of the abdomen. There is a dull and aching nature of the pain.

Phlegmonous

With this form, the pathological process extends to the entire affected organ. The fusion of purulent foci occurs, all the walls of the diseased organ are impregnated.

There is a significant increase in the appendix. Edema of the intestinal walls is formed, they become thicker and friable.

The patient's state of health and condition deteriorates significantly. Requires immediate hospitalization and medical attention.

In the absence of proper treatment, a breakthrough of pus may occur, its distribution over the abdominal cavity.

The pain syndrome subsides, but this is a very alarming sign, indicating peritonitis. Necrosis of nerve endings occurs.

The second phase of the disease is characterized by these symptoms:

• Significant thickening of the walls of the organ is noted;
• The formation of edema and severe hyperemia;
• The mucous membranes swell with fresh erosive and ulcerative lesions, desquamation of the epithelium is observed;
• In the lumen of the appendix, there is liquid pus of gray or green color;
• Multiple end-to-end lesions of the walls of the appendix are formed;
• The presence of leukocyte infiltration of all layers;
• A cloudy or purulent accumulation of fluid is noted in the abdominal cavity.

The average duration of the phlegmonous stage of the disease lasts 24 hours. With this form, all the symptoms characteristic of the catarrhal stage of the disease increase.

The patient's condition deteriorates significantly. The patient can clearly show the place where the pain is localized.

In parallel, nausea increases, vomiting may occur. General signs of intoxication appear - an increase in body temperature, hyperhidrosis, weakness, tachycardia.

The muscles of the anterior abdominal wall are sharply tense. When breathing, the right iliac region lags significantly behind this process.

At this stage, it is very important to carry out an operative surgical intervention on time. In case of late admission to the hospital and refusal of the operation, the following serious complications may develop:

• Wall perforation;
• The inevitability of the development of destructive changes;
• Peritonitis;
• The formation of intestinal obstruction;
• Blood poisoning that is fatal.

Gangrenous

The death of the tissues of the appendix occurs. The gangrenous process occurs on the 2-3 day of the development of the pathological process.

This form of the disease is formed due to several reasons:

• Late access to a doctor for medical help;
• The development of the disease in childhood, when the pathology instantly spreads throughout the child's body;
• The development of pathology in old age.

Patients suffering from autoimmune processes and after suffering severe infectious diseases automatically fall into the risk zone.

Due to the ambiguous clinical picture, it is very difficult to conduct diagnostic studies of this form of appendicitis.

When cells of the appendix die off, nerve endings die. With such processes, patients may not feel the painful effect at all.

During the gangrenous form of appendicitis, all signs of intoxication are noted. The patient is exhausted by weakness, nausea, vomiting may open, hyperthermia appears.

The patient does not feel better after vomiting. All abdominal muscles are in tension, tachycardia is observed.

Appendicular infiltration

This appendicitis is referred to as a complicated form. It is characterized by the accumulation of inflamed tissue around the appendix of the cecum.

The neoplasm has clearly defined boundaries. This complication develops for many reasons, including weak immunity, features of the anatomical location of the affected organ, the type of pathogen.

Most often, this complication is observed in adolescence. The disease is characterized by a sudden paroxysmal pain effect in the umbilical region.

After a few days, the pain syndrome decreases, but all the unpleasant symptoms with signs of intoxication persist.

With a calm course of the disease, with the dynamics of its resorption, conservative therapy is prescribed.

Patients are prescribed strict bed rest, special sparing dietary food, physiotherapy procedures, and taking broad-spectrum antibiotics.

Appendicitis in childhood

In childhood, the course of the disease is different. This process is associated with the finding of internal organs at the stage of formation.

The acute form of the disease is common and dangerous. It threatens with inflammation and tissue necrosis.

The classification of acute appendicitis in children is divided into forms:

• Catarrhal;
• Surface;
• Destructive.

The chronic form is very rare in childhood and is a consequence of the acute form transferred.

With this course of the disease, sclerotic and atrophic changes occur in the process.

In children under the age of 3 years, the following signs of illness are noted:

• Strong and harsh crying;
• Sleep disturbances;
• Lethargic state;
• Refusal to eat;
• Regurgitation;
• Opening of vomiting;
• The baby pulls the legs up to the tummy.

At this age, appendicitis is quite rare. In babies, too small a lumen of the appendix is ​​noted, the lymphatic system is underdeveloped.

Children become very moody, require increased attention, and even refuse their favorite treats.

Localization classification

There are types of ailment relative to the location of the affected organ. There are 2 types of appendicitis:

Classic or traditional

It is diagnosed if the appendix is ​​located in its usual place in the abdominal cavity.

The localization site is marked in the right iliac region. In this case, it is not difficult to determine the pathological process in the appendix of the cecum using a diagnostic study.

Atypical

Pathology is diagnosed when the affected organ in the abdominal cavity is located atypically.

This form of the disease accounts for 20-30% of all cases. The upper part of appendicitis can come into contact with various internal organs, forming the following types of appendicitis:

• Retrocecal - adjacent to the right kidney;
• Medial - adjacent to the small intestine;

In female representatives, the organ can be located in the pelvic region, sometimes left-sided appendicitis is diagnosed.

It manifests itself due to the reverse arrangement of organs or with increased motor activity of the colon.

The problem of atypical appendicitis is diagnosing and making an accurate diagnosis, since all the symptoms in the pathological process are also atypical.

At the first sign of the disease, you should immediately call an ambulance.

Only a doctor should diagnose and make an accurate diagnosis. It is unacceptable to take any medications before the arrival of the doctor.

They can blur the clinical picture and symptoms of the disease. Late seeking medical help and the lack of proper treatment entails dangerous consequences in the form of complications.

They look like abscesses, peritonitis, death. Any medication should be prescribed exclusively by the attending physician. Self-medication is unacceptable and hazardous to health.

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