Appendicitis often causes nonspecific symptoms

Appendicitis with pain and nausea

07/16/2014

Appendicitis (appendicitis) usually occurs in childhood and adolescence and is usually harmless. If those affected go to the doctor late, because they underestimate the symptoms, a life-threatening appendectomy is imminent. Typical symptoms of appendicitis include right lower abdominal pain and nausea. Frequently, non-specific symptoms also occur. The news agency „dpa“ Talked to experts about the key signs that everyone should know.

Symptoms of appendicitis
Patients and family members often do not immediately think of appendicitis for abdominal pain. A gastrointestinal infection is usually the first guess. Because the complaints are often unspecific and can be assigned to other diseases. „Often, initial pains in the upper abdomen occur, which soon shift to the right lower abdomen. Accompanying symptoms are nausea and fever, "reports Prof. Christian Trautwein from the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) to the news agency, but appendicitis could also be associated with the typical symptoms of other diseases such as ovarian inflammation in women Young children under the age of two have a particular problem diagnosing. „Sometimes they have completely different symptoms, such as cough, "explains Tanja Brunnert, a member of the Association of Pediatricians (BVKJ) to the news agency.

Most appendicitis occurs in childhood and adolescence. „The primary disease age is between 10 and 15 years, "says the pediatrician, boys are more likely to be affected than girls, and later, at the age of 15 to 20 years, many are still suffering from appendicitis, after which the incidence decreases markedly.

Appendicitis needs to be treated promptly
The appendix or appendix is ​​the blind end of the large intestine, which at the end of the small intestine is directed downwards into the abdominal cavity. Even a small cherry stone can trigger an inflammation in this area. „The appendix has only one entrance, no exit and can easily clog up, "says Brunnert „Often there is no specific cause, the worm appendage can ignite on its own“. Regardless of the cause, appendicitis must be treated promptly. Otherwise, a life-threatening appendicitis is threatened, in which the intestinal wall is perforated and germs can enter the abdomen. This can lead to a severe inflammation of the peritoneum (peritonitis), which in the worst case can be fatal.

If there is a suspicion of appendicitis, the doctor uses the blood count of the patient to check whether the white blood cells and a specific protein are increasingly present in the blood. Both serve as an indication of an inflammatory reaction. In addition, he gropes the abdomen of the person on hardening and pressure pain. Particularly typical is the so-called release pain in appendicitis. The doctor pushes a certain area on the stomach and lets go again. Usually then an ultrasound examination takes place. „The appendix is ​​thickened in an appendicitis, this can be seen in the ultrasound often good“, reports Trautwein. In addition to appendicitis, an appendicitis can also occur, a kind of precursor, which goes back by itself.

When is operated on appendicitis?
It is not always necessary to operate on appendicitis. Sometimes, though rarely, antibiotic inflammation can be contained, as Prof. Hans-Peter Bruch, president of the German Association of Surgeons (BDC) told the news agency.

If surgery is necessary, there are essentially two surgical procedures. On the one hand, a so-called alternating cut can be used in which the abdomen of the patient is opened above the cecum, so that the inflamed tissue can be removed. On the other hand, it is possible to perform a laparoscopy, which is considered more gentle. The doctor sets three very small cuts through which the instruments, including a camera, are guided into the abdomen. Also with this method, the cecum can, if necessary, be removed.

If the inflammation has already led to an appendectomy, a larger abdominal incision is unavoidable. After removal of the inflamed tissue, the entire space must be rinsed to reduce the germ load.

Risks and complications of cecal surgery
The most common complications of cecal surgery include problems with general anesthesia and wound healing disorders. „However, the complication rate is low, "explains Trautwein, adding that there is another danger, „that during the operation bacteria enter the abdominal wall, which can cause an abscess within a few days, "said Bruch.Then another operation is necessary, in which the abdominal wall is opened again, in order to let the secretion drain off OP on, it can also come in the episode to intestinal obstruction and other difficulties.

After a successful appendectomy, the patient must first conserve. The duration of the regeneration period depends on the treatment method, the course of the operation and the individual pain sensation of the affected person. Most patients can be discharged from the hospital one to three days after a laparoscopy. „Especially young patients are usually fit again after only a few days, "says Trautwein, who says that if an abdominal incision has to be used, the patient usually stays in the clinic for five to seven days. „With a severe peritonitis, it can also be 14 days. "The pediatrician advises to save some time after the hospital stay, which also includes two to three weeks to pause with the sport and not heavy lifting Not only the externally visible scar must heal, also the inner tissues have to regenerate. „It takes about 14 days for the tissue to be fully loadable, "explains Bruch.