Gangrenous appendicitis and purulent peritonitis. Gangrenous form of appendicitis. Complication of purulent appendicitis with peritonitis

Appendicitis is a nonspecific inflammation of the vermiform appendix (appendix), which can manifest itself in different forms: simple or superficial, phlegmonous, gangrenous, perforated. The destructive stages are considered the most dangerous due to the increased risk of complications and spread inflammatory process over the entire abdominal cavity. How to recognize and treat gangrenous appendicitis?

What is gangrenous appendicitis

Gangrenous appendicitis is a form of acute destructive inflammation of the appendix, which is characterized by necrosis (death) of appendix tissue. Most often develops as a result of untreated acute simple appendicitis.

The appendix is an extension of the cecum

As a rule, this form occurs 2–3 days after the first symptoms appear in adults, but in children this process can occur much faster. The main difference between gangrenous appendicitis is the severity of the patient's condition. Inflammation of the appendix is accompanied by pronounced symptoms of intoxication (increased temperature up to 38°C, increased heart rate, palpitations, general malaise), while the pain may not be as severe as with the usual form.

The exact form of appendicitis can only be determined during surgery; classification only provides the opportunity to assess the stages of the process and the risk of possible complications.

In case of rupture of the tissues of the appendix and the release of its contents, a perforated gangrenous form develops, which manifests itself acute pain in the right lower abdomen with tension in the muscles of the anterior abdominal wall.

The prognosis for any form of appendicitis is favorable if you consult a doctor in time and undergo emergency surgery.

Causes

Often, gangrenous appendicitis occurs as a result of untimely or inadequate treatment of simple forms of inflammation of the appendix. In rare cases, the cause may be a disruption of the blood supply to the appendix, which will lead to necrosis and tissue death. Risk factors in this case are associated cardiovascular diseases(arteries, veins, portal hypertension), which are more often diagnosed in old age.

Thus, the main causes of gangrenous appendicitis are:

immunodeficiency diseases;
complication of a simple form of appendicitis;
impaired blood supply to the appendix (as a result of atherosclerosis of the arteries, thrombosis of the veins);
mechanical damage to the appendix.

Symptoms

There are a number of common and local symptoms, which may indicate the development of gangrenous appendicitis.

Malaise, weakness.
Temperature rises to 38°C.
Decreased appetite.
Deterioration of sleep.
Cardiopalmus.

Local symptoms:

Features of gangrenous-perforated appendicitis

Perforated gangrenous appendicitis is characterized by:

severe condition;
severe general malaise;
temperature rise to 39°C;
sharp “dagger” pain in the abdomen, limited or diffuse tension in the muscles of the anterior abdominal wall.

Important! Perforated form of appendicitis is an indication for emergency surgical intervention.

Diagnostics

Diagnosis of gangrenous appendicitis is a difficult task, because it initial signs may appear blurred or atypical. However, the diagnosis algorithm remains the same for all forms of acute inflammation:

How to identify appendicitis - video

Treatment

The only treatment for gangrenous appendicitis is surgical removal vermiform appendix. Therapy consists of preoperative, surgical and postoperative periods.

Main types of operation:

classic appendectomy - a 10–12 cm incision is made, through which the appendix is brought out and removed, then a suture is placed on the cecum. Surgical intervention is necessarily accompanied by an examination abdominal cavity and installation of drainage;
transluminal appendectomy (rarely used) - appendix removed through natural openings of the human body using special flexible instruments;
laparoscopy - 2-3 holes are made, through one of them a special instrument is inserted - a laparoscope, which transmits an image of the operation to the monitor. This access is less traumatic. In addition, it allows you to shorten the postoperative period.

The decision which access to use is made by the doctor depending on the patient’s condition and the presence of complications.

Important! If you want to have laparoscopic surgery, but the doctor insists on open surgery, then you should not argue with the specialist. In some cases, classic appendectomy is less life-threatening.

Postoperative period

The postoperative period for gangrenous appendicitis has its own characteristics.

Besides drug therapy, in the postoperative period, physical procedures are often prescribed, such as exercise therapy, massage, therapeutic exercises, which are designed to restore the functions of damaged systems.

Main directions of therapy - table

Direction of therapy	Means and preparations
Antibacterial therapy	cephalosporins (Ceftriaxone, Cefixime); fluoroquinolones (Levofloxacin, Ofloxacin).
Anesthesia	narcotic (Promedol); non-narcotic analgesics (Analgin, Ibuprofen, Paracetamol).
Infusion therapy	saline solutions; Xylate; Rheosorbilact.
Prevention of thromboembolism	bandaging elastic bandage lower extremities; early activation; heparins.
Dressings	timely replacement of bandages

Drugs prescribed after surgery - gallery

Antibiotic Levofloxacin Ceftriaxone - antibacterial drug Paracetamol - non-narcotic pain reliever Glucose solution

Traditional methods

Since appendicitis is emergency in surgery and requires immediate surgical intervention, you should not resort to unconventional methods of treatment before the ambulance arrives. But after an appendectomy the remedies traditional medicine will be useful. The following will help alleviate the patient’s condition:

Chamomile decoction: 2 tbsp. l. pour one glass of boiling water over the raw material, leave on low heat for 20 minutes, then cool and strain through cheesecloth. Use 3-5 times a day.
Infusion of cranberries and lingonberries: wipe and pour boiling water over the berries. Drink in small sips throughout the day.
Calendula decoction. 1 tbsp. l. Pour a glass of boiling water over the dried flowers of the plant and leave in a steam bath for 5–10 minutes. Drink 1/3 glass 3 times a day.

Diet

Diet is an important part of the postoperative period, allowing you to restore the functions of the gastrointestinal tract as quickly as possible, speed up the healing process and prevent the development of infection.

In the first 12 hours, food and liquid intake is prohibited.
In the following hours, in the presence of peristalsis (gas passage) and the absence of vomiting, the diet is expanded to boiled water, low-fat broth, liquid porridge.
If, after the gradual introduction of liquid products, the patient’s condition does not worsen and his appetite improves, then they are allowed to add to the menu mashed potatoes, boiled chicken, rice, low-fat yogurt.
After a few days, it is recommended to eat foods rich in fiber: oatmeal, dried fruits, vegetables, buckwheat porridge.

In addition, it is important to follow a diet:

eat food at the same time in small portions - this will contribute to better absorption of nutrients;
Eating a variety of foods throughout the day will increase your appetite;
adhere to the drinking regime - 1.5–2 l - the optimal volume for quick recovery body after surgery.

What can you eat after an appendectomy:

low-fat broth;
lean meat (boiled or steamed);
boiled vegetables;
dairy products(kefir, yogurt, sourdough);
mashed potatoes;
porridge (semolina, rice).

Approved products - gallery

Chicken bouillon Boiled vegetables Dairy products Chicken fillet

The following should be excluded from the diet:

fried, spicy, smoked dishes;
sweets (baked goods, products with cream);
products that increase gas formation (cabbage, sparkling water);
alcohol.

Prohibited products - gallery

Carbonated drinks Sweets Alcohol Fast food

Lifestyle

A healthy lifestyle contributes to the rapid and effective rehabilitation of a patient after an illness and includes:

moderate activity;
balanced diet;
adherence to daily routine;
limiting heavy physical activity.

Possible consequences and complications

The development of gangrenous appendicitis is considered an extremely dangerous condition that can lead to serious consequences and even death.

The most common complications include:

appendicular abscess;
appendicular infiltrate;
purulent peritonitis;
septic thrombophlebitis.

Gangrenous appendicitis is a dangerous condition that requires immediate diagnosis and qualified assistance. Remember, inflammation of the appendix will not go away on its own. The disease can only be cured with surgery.

Gangrenous appendicitis is one of the types of inflammation and tissue death of the appendix. In this case, the resulting inflammatory processes that accompany the occurrence of gangrenous-acute appendicitis are purulent in nature. This disease poses a serious threat to human life and health, so it must be eliminated as quickly as possible.

A disease such as gangrenous appendicitis can be detected in a person only through a visual assessment of the condition of this appendage of the cecum. The main, and most dangerous, feature of a gangrenous appendix is that any surgical manipulation in this type of pathological process can provoke rupture of the appendix, which will lead to its contents entering the abdominal cavity.

The gangrenous form of appendicitis is one of the diseases of the cecal appendage; its development is most often the cause fatal outcome. This pathology can be cured only if the patient promptly seeks medical help from qualified specialists at the first signs of the development of the pathological process.

Factors contributing to the formation of the disease and its form

The most common reasons that cause gangrenous appendicitis in humans are:

age-related changes in the structure of the human vascular-circulatory system;
the presence of hypoplasia of the blood arteries that are located next to the appendix; the development of such a pathological process is in most cases observed in children who have congenital form hypoplasia;
the presence in the vascular-circulatory system of the body of blood clots (blood clots that interfere with normal blood flow);
the presence of a disease such as atherosclerosis of blood vessels and arteries, which are localized in the intestines;
the development of any infectious diseases in the human body.

Gangrenous appendicitis, depending on the stage of its progression, can have the following forms:

Phlegmonous form of the disease. Phlegmonous appendicitis is an intense accumulation of pus in the appendix, and is also characterized by the occurrence of severe swelling of the inflamed appendix. This form of gangrenous inflammation of the cecal appendage forms a day after the onset of the disease.
Gangrenous-perforated appendicitis. This stage of development of inflammation of the appendix represents a penetration of its wall affected by necrosis, as a result of which its contents enter the abdominal cavity. Intoxication of the body occurs. This process is called perforation.

If, within 2 days after the onset of a purulent inflammatory process in the appendix, the patient did not pay attention to the characteristic manifestations of this pathological process and did not receive appropriate medical care, then as a result of the progressive death of the tissues of the appendix, acute gangrenous appendicitis is formed. The main feature of the flow acute form The disease is that due to necrosis of the appendix tissue, the nerve endings located in it lose their sensitivity, and the patient ceases to feel pain.

Symptoms accompanying the development of the disease

The clinical manifestations of gangrenous appendicitis are ambiguous, which significantly complicates the diagnosis based on the symptoms accompanying the development of this pathological process. In addition, due to the death of tissues and cells of the inflamed appendage of the cecum, its nerve endings also die, which is characterized by a decrease in the intensity characteristic of the disease painful sensations, and in some cases, symptoms may be completely absent.

On initial stages purulent inflammation appendix, a sick person may exhibit the following signs of this disease:

severe nausea, accompanied by frequent vomiting, while vomiting does not bring any relief to the person’s condition;
feeling constant weakness and general malaise;
the abdominal muscles are constantly in a tense state;
pain on the right side in the iliac region; in this case, the pain syndrome occurs suddenly, and as a result of necrosis of the nerve endings of the appendix, it gradually fades away or disappears altogether;
no selection feces as a result of impaired intestinal motility;
feeling of chills;
dryness of the mucous membranes and tongue, while the tongue may have a yellow tint;
intoxication of the body, which manifests itself in the form of a significant increase in body temperature; however, in some cases the temperature may remain normal or drop slightly.

Method of treating the disease

The presence of any type of appendicitis in a person indicates the need for surgical intervention. The gangrenous form of inflammation of the appendix is no exception. Methodology surgery to remove the appendix may be as follows:

Classic operation. Carrying out classical method Removal of the appendix is carried out by opening the patient's abdominal cavity. After the appendix is removed, sutures are placed at the incision site. If the contents of the inflamed appendix enter the peritoneal cavity during surgery, it is washed and drainage is installed.
Transluminal technique of surgical intervention. This operation is characterized by the removal of the inflamed appendage of the cecum through natural physiological openings on the patient’s body. This type of operation is used extremely rarely these days.
Laparoscopic method. During laparoscopic surgery, a puncture is made in the wall of the abdominal cavity, through which a surgical instrument with a camera is inserted, which is used to remove the appendix. The laparoscopic method of surgical intervention is the safest and reduces the risk of intoxication of the body to a minimum.

After surgery, the patient is prescribed a special rehabilitation course, since removal of a gangrenous appendix is quite a serious burden for human body. The postoperative course includes the following:

Monitoring the general condition of the patient. Such control includes regular measurements of body temperature, flushing drainage and changing body dressings, regular laboratory test blood samples.
Carrying out detoxification therapy.
Administration, if necessary, of appropriate painkillers into the patient’s body.
Conducting massage and regular breathing exercises. The intensity of such medical procedures is selected individually for each patient and depends on the general condition of the person.

The patient is prescribed an individual course of dietary nutrition, which allows to relieve the load on the patient’s gastrointestinal tract. During the first day after the operation, the patient is allowed to consume only low-fat chicken or potato broth, as well as weak herbal infusions. After some time, the patient’s diet gradually expands. However, throughout the entire dietary course, the patient should not consume spicy, fatty, smoked, fried foods and various alcoholic beverages.

Gangrenous appendicitis is a serious pathological process, the development of which can lead to the death of the patient. Therefore, when the first manifestations of this disease occur, it is necessary to consult a doctor as soon as possible.

Gangrenous appendicitis is a pathology that is characterized by tissue necrosis of the appendix and a typical clinical picture, which allows it to be differentiated from other forms of the inflammatory process directly in the appendix. Most often it occurs acutely and provokes sufficiently developed serious consequences for good health. That is why it is so important to promptly seek help from a doctor who will determine the causes of the pathological process and prescribe therapy.

General information

Gangrenous appendicitis is a type of purulent inflammation of the appendix, which is based on irreversible destruction. Most often, changes of a necrotic nature are observed in small areas of the appendix. Gangrenous inflammation is a form of acute variant of the disease and appears only at a certain stage of its development (2-3 days of inflammation).

The main reasons for the development of pathology

Acute gangrenous appendicitis develops when the inflammatory process in the appendix is not noticed during the first day. Then the normal sensitivity of the nerve endings disappears, so the pain syndrome may disappear. Many patients decide that the danger has passed and they can postpone their visit to the doctor for a while. Such neglect of one's own health can lead to peritonitis.

Experts consider the following to be the main risk factors for the occurrence of such pathology:

Elderly age.
Formation of blood clots.
Atherosclerosis of intestinal arteries.

All these factors indicate that the immediate causes of the development of pathology are so-called microcirculatory disorders. Their result is considered to be a violation of normal blood circulation, and as a consequence - necrosis of the appendix. Other elements of pathogenesis (infection, autoaggression immune cells) join only in the second place, only aggravating the course of the pathology.

What signs indicate pathology?

In the acute period, repeated vomiting occurs, which constantly exhausts the patient and does not bring long-awaited relief. Due to intoxication of the body due to the development of a putrefactive inflammatory process, the temperature may remain normal or reduced.

Gangrenous appendicitis manifests itself in the form of “toxic scissors” syndrome. The patient has severe tachycardia (heart rate about 100 beats per minute), but the temperature does not increase.

The patient's tongue is dry with a characteristic yellowish coating. In the case of primary gangrenous appendicitis, the symptoms may be slightly different:

Painful discomfort in the right iliac region, which suddenly appears and quickly subsides.
The abdomen is hard and painful.
The patient's condition is assessed as serious.

If a person does not receive adequate and timely treatment, after this form of the disease, gangrenous-perforated appendicitis develops. The pathology is characterized by perforation of the wall of the appendix itself. During the period of immediate rupture, a person experiences severe pain, which over time begins to gradually spread throughout the entire abdomen. Due to increasing intoxication of the body, the temperature rises and obvious tachycardia appears. The tongue becomes very dry, the coating acquires a brownish tint. The patient suffers from severe vomiting.

Diagnostic measures

If you experience any of the above symptoms, you should immediately seek help from a doctor. If this pathology is suspected, the specialist initially conducts a physical examination of the patient. On palpation, as a rule, tension in the abdominal wall is observed, and the abdomen is moderately distended. A series of laboratory tests are then ordered, including blood and urine tests. Additionally may be required ultrasonography, radiograph and computed tomography. Based on the test results, the doctor can confirm the diagnosis of gangrenous appendicitis.

Treatment methods

Therapy involves surgical removal of the appendix. Appendectomy is performed traditionally or through laparoscopy.

In the first case, the doctor removes the appendix through an incision in the abdominal wall. Typically, this procedure is performed using general anesthesia.

Surgery for appendicitis using laparoscopy is less traumatic. The surgeon makes several microscopic punctures in the abdominal wall through which instruments for manipulation are inserted. The most important of them is the laparoscope - a tube with a camera at the end. During the operation, the doctor receives an image from it on a computer screen, which allows for the most accurate surgical manipulations.

Postoperative period

The postoperative period in patients with such a fairly common diagnosis has a number of features:

The use of antibacterial and painkillers.
Infusion detoxification therapy using saline solutions, refortan, glucose and albumin.
Daily blood tests.
Prevention of ulcers and thromboembolic complications. In the postoperative period, patients are prescribed gastric secretion blockers (Kvamatel, Omez) and anticoagulants (Clexane).
Daily dressings and washing of wounds.
Exercise therapy, special massage, breathing exercises.

Appendicitis surgery is a fairly serious surgical procedure. To prevent the development of complications in the future, you should use the recommendations below.

Let's talk about nutrition

This pathology is characterized by problems with intestinal motility, so after surgery Special attention should be given to nutrition.

On the first day, you are allowed to consume low-fat kefir, mineral water without gases and light chicken broth. On the second day, if the postoperative period is not complicated negative consequences, you can add mashed potatoes, liquid porridge with water and cottage cheese casserole to your diet. Every other day, food needs to be varied as part of diet No. 5. It's better to give up fatty foods spicy food and smoked meats.

Possible complications

This pathology is considered very dangerous, as it can lead to the development of complications quite dangerous to health. This process is especially critical for young patients.

What negative consequences can be accompanied by gangrenous appendicitis?

Purulent peritonitis. This is a rather dangerous condition that requires immediate surgical intervention. If help is not provided promptly, blood poisoning may occur.
Appendicular infiltrate. In the area of the inflamed appendix, a local conglomerate gradually forms, consisting mainly of organs and tissues. This problem always requires long-term conservative therapy.
Septic thrombophlebitis. The inflammatory process develops in the venous walls. As a result, it leads to the formation of blood clots in the lumen of the vein.
Local purulent abscess. Such formations predominantly develop in the diaphragm area.

Appendicitis should not be ignored. The purulent gangrenous version of this pathology requires immediate treatment. Otherwise, the likelihood of complications and even death increases. Such inflammation is especially dangerous for children; all pathological processes occur several times faster in them.

Is a prerequisite rehabilitation period. Therapeutic and preventive nutrition after excision of the appendix contributes to the patient’s speedy recovery and normalization of the digestive system. In this article we will talk about the basics of such a diet, introduce sample menu and a list of foods that can and cannot be consumed.

Diet after appendectomy

Diet Basics

After an appendectomy, all foods that irritate the mucous membrane of the digestive tract are excluded from the daily diet. You should generally forget about spicy, sour and salty foods, well, at least for the recovery period.

How long you need to stay on such a diet is determined by the attending doctor, taking into account the patient’s condition and the complexity of the operation.

You should also limit your consumption of baked goods and confectionery. Excessive consumption of flour can cause rupture of surgical sutures. It is better if you follow all the doctor's recommendations. Only in this way will you be able to avoid irreversible consequences. This is why diet after appendicitis is so important.

I would also like to note that DP after appendectomy in children and adults is practically the same. But mature patients will need to forget about alcohol and cigarettes, and children should not abuse sweets and starchy foods.

What can you eat immediately after laparoscopy?

Immediately after laparoscopy and for ten hours, the patient should refrain from eating. In principle, during this period there is no particular appetite. After the first day, a person is allowed to drink water in which rice cereal or lean chicken broth was boiled. As an option, you can drink jelly made with a fruit base.

When dieting after appendicitis, on the first and second days you can eat:

secondary fresh chicken broth;
mashed potatoes without butter and milk;
water-based rice broth;
vegetables of the pumpkin family, boiled and pureed;
non-acidic yoghurts without preservatives and dyes;
boiled chicken without skin and fat, minced in a blender or finely chopped with a knife.

After removal of the cecum, eat small portions and divide them into five meals.

Medical nutrition for a week

At the next stage after laparoscopy, the patient is allowed to eat only lean food, prepared only by boiling. These can be slimy porridges and soups. Such dishes are easily digestible and do not burden the digestive system. It is best to give preference to chicken or vegetable broth.

Puree vegetable soups that can be made from pumpkin, cauliflower, zucchini, potatoes, carrots. You can flavor this soup with a handful of rice. Such a fortified dish will help the patient return to normal faster.
Dill, basil, parsley and any other greens have a beneficial effect on digestive tract and helps the stomach digest food faster. Therefore, it is also recommended to add greens to first and second courses.
The basis of the diet after appendectomy is drinking plenty of fluids. You will need to drink plenty of fluids (at least two liters per day) to stay hydrated. Drink plain water, homemade juices, jelly, herbal teas.

Meals for the next two weeks

Every day the diet will become more varied. After 2-3 days, your body will be able to process heavier foods, such as meat, low-fat sour milk, buckwheat and other cereals.

At the same time, you need to monitor the condition of your body. Any product consumed should not cause constipation, diarrhea or pain.

After removal of the cecum, a week later you are allowed to eat low-fat and non-acidic yoghurts, cottage cheese, kefir and yogurt. These products contain bifidobacteria that are beneficial for the intestinal microflora. In addition, such easily digestible food does not irritate the gastrointestinal mucosa.

Eat more fiber

The postoperative diet also includes the consumption of foods rich in fiber. Indeed, often taking medications or bed rest, which is indicated for patients after removal of the appendix, can cause problems with stool. And fiber is just what you need in this case. You can eat rice, buckwheat, baked apples, dried fruits and boiled carrots. But before you eat one of these foods, consult your physician.

Pumpkin is one of the most valuable products in the kitchen. It contains almost all vitamins. Therefore, while on a diet after removal of the cecum, you can include this product in your individual menu.

In addition to everything, I would like to say that the diet for appendicitis is individual in each case. It all depends on the degree of complexity of the disease and the patient’s immunity.

What is prohibited to eat

Now, let's look at the list of prohibited products. It is not that long, but if you have had appendicitis removed, the diet must be strict and you should definitely read this list:

After the appendix is removed, a strict diet is established. First of all, the doctor will recommend that you limit your consumption of “white poison,” i.e., salt. It would be better if you completely abandon this product, at least for the rehabilitation period.
Tomatoes, peas, legumes are prohibited.
You should generally forget about various spices and seasonings during the diet.
Mayonnaise, smoked meats, and fried foods only cause bloating, which is extremely undesirable. The same goes for soda.
Honey is a questionable product. You should consult your doctor about its consumption.

The postoperative diet when removing the appendix is aimed at unloading the body and facilitating the digestion process. Therefore, you should definitely follow it. In addition, this diet helps you lose weight. Agree, good news for those who are overweight.

Appendicitis can have different etiologies, so a separate one is selected for each patient. dietary food. Let's consider the types of diets for each case.

PP for gangrenous appendicitis

First of all, in case of gangrenous appendicitis, you need to remove all foods that irritate the gastrointestinal mucosa, namely: fish, potatoes, sour fruits and vegetables.

The dietary table for the removal of gangrenous appendicitis consists of the following ingredients:

you can eat non-acidic fruits and vegetables (as mentioned above);
light vegetable or chicken soups;
all porridges except peas;
consume non-acidic and low-fat fermented milk;
Drinks include fruit compotes and weak teas.

After surgery for appendicitis, a diet of this plan is followed for two weeks.

How to eat properly after appendectomy?

The operation to remove appendicitis is a fairly common surgical procedure. According to statistics, this disease accounts for 65% of all calls for abdominal pain. With an uncomplicated course and proper care the patient recovers quite quickly. Nutrition is important in this condition.

Diet is especially important after appendicitis in children, because their body has not yet learned to cope with such significant stress.

What is appendicitis? Appendicitis is inflammation of the appendix of the cecum. There are chronic and acute appendicitis.

Symptoms of acute appendix:

abdominal pain gradually moving to the right side;
nausea and vomiting (usually one-time);
constipation (less commonly diarrhea);
general malaise - lethargy, rapid heartbeat, perspiration.

In chronic cases, the patient is worried about periodic pain. This type can be treated with medication. For acute appendicitis the only way treatment - appendectomy (surgical intervention by removing the inflamed appendix). This operation is carried out under general anesthesia. It does not last long for uncomplicated disease. If the patient develops peritonitis (inflammation of the abdominal cavity), then surgical intervention will be much more serious.

Nutrition after appendicitis removal in the first days after surgery

After surgery, you should not eat anything for the first day. This is due to the fact that during this operation, sutures are placed directly on the intestinal wall. If you start eating immediately after removal, the stitches will most likely simply come apart. But as a rule, the sick person already has no appetite.

The body comes out of anesthesia, and against this background, symptoms such as nausea and weakness are often present. In this state there is no desire to eat food. If everything goes well, then at the end of the first day after the operation you can drink not a large number of low-fat chicken broth or rice broth.

The diet for the first three days should consist of the following products:

low-fat chicken broth;
low-fat kefir or natural yogurt;
baked apples;
rice cooked in water;
zucchini or pumpkin puree (according to season);
white chicken meat, thoroughly crushed.

Meals should be provided in small portions, 5–6 times a day. Such fractional meals will help the intestinal walls heal faster in the first days.

For more serious types of appendicitis - purulent or gangrenous, the diet should be even more strict.

Nutrition for the first weeks

When the first, most hard days After the operation, other foods are gradually introduced into the patient’s diet. You need to start with small quantity new product and gradually increase it to normal volumes. Here are the most healthy dishes which are recommended for use after appendectomy:

Vegetable puree - beets, carrots, potatoes. Vegetables are rich in fiber, and this normalizes the peristalsis of the diseased intestine after surgery.
Soups made from cereals and vegetables in water or low-fat chicken broth.

Meat broths are contraindicated these days.

A variety of porridges - rice, buckwheat, oatmeal. They need to be cooked in water.
Low-fat fermented milk products - cottage cheese, kefir, yogurt. These products are easily digestible and have a beneficial effect on the intestinal microflora.
Meat dishes are made exclusively from white chicken meat. Steam cutlets, meatballs, puddings. Protein is needed by the body to restore energy reserves after surgery.
Fruits. They contain many useful substances that are so necessary for a weakened body. However, they can only be consumed in very limited quantities, because the fruit contains a lot of sugars, and they are contraindicated after removal of the appendix.
Liquid. You need to drink a lot - dried fruit compotes, fruit drinks, jelly, juices and just mineral water without carbon - all these drinks will help the body quickly remove all toxic substances.

Food should not be salty or spicy.

In the first weeks after removal of appendicitis, patients are advised to grind dishes until they become mushy. This will help the operated intestines digest it faster and easier. It is important to note that such a diet should be followed for about 1 month, gradually returning to the usual eating regimen. Your doctor will decide exactly how much you should follow this diet.

List of prohibited products

Such operations are very stressful for any person. Therefore, doctors do not recommend putting additional stress on a weakened body. During this intervention, it is strictly forbidden to eat:

fatty meat and soups made from it;

carbonated sweet drinks;

seasonings (ketchup, mayonnaise, sauces);

Daily meals for appendicitis include all the dishes mentioned above. They need to be alternated with each other in order to diversify the diet and saturate the weakened body.

How long does the postoperative period of gangrenous appendicitis last?

Acute gangrenous appendicitis is perhaps one of the most dangerous types of inflammatory process associated with the appendix. Most often, the presented form develops due to a late visit to a specialist and incorrect diagnosis (for example, if the phlegmonous form was not identified). In fact, experts assess the condition as a continuation of phlegmonous appendicitis, the symptoms of which worsen and may even correspond to gangrene - which is why treatment is strongly recommended to begin as early as possible.

Reasons for the development of the condition

Gangrenous appendicitis is directly associated with the algorithm for the formation of the inflammatory process in the area of the appendix. Mostly we are talking about a long duration of the condition. The main risk factors in terms of the development of primary gangrenous algorithm should be considered:

advanced age and associated changes in the structure and structure of blood vessels;
childhood and genetically determined hypoplasia (displacement) of arteries in the appendix area;
atherosclerotic damage to the arterial walls in the intestinal area;
the formation of blood clots in the arteries and veins of the appendix.

The presented data fully indicate that the direct causes of the acutely formed condition are precisely those disorders that are associated with microcirculatory functions. Their result should be considered destabilization of the blood circulation process in the process itself and, as a consequence, its necrosis (the appearance of necrotic tissue). All remaining “chains” of development, namely infectious lesions, destabilization of the outflow of contents from the appendix and much more, will be added subsequently, only aggravating general course process, causing complications and negative symptoms.

It also happens that the main factor in the development of such a condition as gangrenous appendicitis is the transformation of simple forms of appendicitis into destructive ones. This can happen mainly due to incorrect or late initiation of surgical treatment. In such a situation, the appendix will be subject to purulent melting when the patient has to stay in the hospital after surgery, which takes a long period of time.

Symptoms of the disease

All types of appendicitis are similar in clinical manifestations. However, each of the varieties is characterized by its own characteristics. This will apply especially to acute gangrenous appendicitis. If it is a consequence of such a form as phlegmonous inflammation of the appendix, then the subsidence of painful sensations or even their disappearance will be characteristic. It is strongly recommended to pay attention to the symptoms and their additional features:

subsidence of symptoms is associated with the death of nerve endings in the walls of the appendix as a result of necrosis;
In patients, repeated vomiting is identified due to increased intoxication of the body. While with other types of the disease it is completely absent or one-time;
during the examination, the specialist can identify significant dryness in the tongue area, tension in the muscles of the peritoneum and its walls;
during palpation, the right iliac region can be extremely painful. Recovery will last quite a long time, even after surgery.

In the blood test, the level of leukocytes is moderately elevated, although the shift of the formula to the left can be significant. It is necessary to pay special attention to what the consequences of such a condition as gangrenous appendicitis may be.

The danger of gangrene of the appendix

In a condition such as gangrenous appendicitis, the most formidable and critical consequence should be considered a diffuse form of peritonitis. It is formed when an outpouring of purulent contents from the appendix area directly into the peritoneum is identified. In some situations, peritonitis is limited (localized). This can happen if spikes have time to form, which prevent the algorithm from spreading. Specific to the presented complication is a sudden change in the general clinical picture, which can last even longer than usual without appropriate treatment.

Painful sensations no longer have any specific localization. They begin to intensify and spread to the entire surface of the peritoneum. The patient's condition is rapidly worsening: severe tachycardia can be identified (pulse rate more than 100-120 beats per minute), while a whitish coating forms on the tongue. Also, experts pay the most close attention to the fact that consciousness turns out to be sluggish and inhibited. In this case, the stomach ceases to take part in the respiratory process, repeated vomiting is formed, which does not bring any relief to the patient. After the operation they stop, but you need to know exactly how long the pathological condition lasts.

For the gangrenous-perforated form of appendicitis, completely different clinical manifestations should be considered characteristic:

lack of intestinal peristalsis and abdominal tension;
signs of peritoneal irritation are formed;
may form paralytic form intestinal obstruction;
in the analyzes the number of blood leukocytes significantly increases, the ESR increases to critical levels (40-60 mm per hour).

Protein and various casts (eg, waxy) are often identified in the urine, which is evidence of a toxic form of nephritis. How gangrenous appendicitis is treated deserves special attention.

Features of the treatment of such inflammation

The leading method of treatment for gangrenous appendicitis is emergency surgery. If there is any suspicion of peritonitis, a so-called open laparotomy is performed under general anesthesia. In this case, the abdominal wall is opened along the midline, the inflamed appendix or any part of it is removed, and a detailed examination of the abdominal cavity is performed.

A toilet is required internal organs and peritoneum, it is washed with antiseptic solution. The surgical wound should not be completely sutured, because special tubes remain in it to provide drainage. They are required to remove accumulated exudate, as well as to irrigate the peritoneum with antiseptic products.

Surgical intervention is traditionally complemented by long-term drug therapy. To eliminate processes associated with intoxication, intravenous infusion solutions are provided, and antibiotic compounds may be prescribed.

Can there be complications after surgery?

It is necessary to take into account that with the gangrenous form of appendicitis, the period after completion of the operation will be long and quite difficult. Certain complications may arise, for example:

formation of infiltrate;
suppuration of a surgical wound;
external or internal bleeding from the problem area;
abscesses in the peritoneum;
fistulas in the intestinal area

Also, a person may have a dehiscence of the sutures of the wound or even the stump of the appendix. An equally serious consequence is peritonitis, which develops before surgery.

Features of recovery after surgery

Speaking about gangrenous appendicitis, the postoperative period of which can be long, it is strongly recommended to pay attention to some features of the process. The fact is that it will differ from the simple form of the state in the need to ensure forced antibacterial therapy. In particular, the use of Cephalosporins, Levofloxacin and other names will be required.

Correct and complete pain relief through the use of various forms of analgesics, in particular narcotics, should be considered strongly recommended. Specific infusion therapy may be required to avoid intoxication. We are talking about the use of saline solutions, glucose, albumin and other names.

In addition, for the final relief of gangrenous appendicitis, it will be necessary to exclude thromboembolic complications and stress ulcers of the stomach and intestines. It will also be very important to check blood counts daily and carry out timely dressings. By the way, these are the ones that should be done daily. Assessment of the healing process and the exclusion of necrotic processes should also be ensured with enviable regularity.

Exercise therapy, qualified massage and respiratory gymnastics are mandatory. Their number and frequency of implementation will be determined by the overall condition of the patient and whether he can actually move and how complicated this process is.

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1.Can cancer be prevented?

The occurrence of a disease such as cancer depends on many factors. Provide yourself complete safety no man can. But significantly reduce the chances of occurrence malignant tumor everyone can.

2.How does smoking affect the development of cancer?

Absolutely, categorically forbid yourself from smoking. Everyone is already tired of this truth. But quitting smoking reduces the risk of developing all types of cancer. Smoking is associated with 30% of deaths from oncological diseases. In Russia, lung tumors kill more people than tumors of all other organs.

Eliminating tobacco from your life is the best prevention. Even if you smoke not a pack a day, but only half a day, the risk of lung cancer is already reduced by 27%, as the American Medical Association found.

3.Does excess weight affect the development of cancer?

Look at the scales more often! Extra pounds will affect more than just your waist. The American Institute for Cancer Research has found that obesity promotes the development of tumors of the esophagus, kidneys and gallbladder. The fact is that adipose tissue not only serves to preserve energy reserves, it also has a secretory function: fat produces proteins that affect the development of a chronic inflammatory process in the body. And oncological diseases appear against the background of inflammation. In Russia, WHO associates 26% of all cancer cases with obesity.

4.Do exercise help reduce the risk of cancer?

Spend at least half an hour a week training. Sport is on the same level as proper nutrition when it comes to cancer prevention. In the United States, a third of all deaths are attributed to the fact that patients did not follow any diet or pay attention to physical exercise. The American Cancer Society recommends exercising 150 minutes a week at a moderate pace or half as much but at a vigorous pace. However, a study published in the journal Nutrition and Cancer in 2010 shows that even 30 minutes can reduce the risk of breast cancer (which affects one in eight women worldwide) by 35%.

5.How does alcohol affect cancer cells?

Less alcohol! Alcohol has been blamed for causing tumors of the mouth, larynx, liver, rectum and mammary glands. Ethyl alcohol breaks down in the body to acetaldehyde, which is then converted into acetic acid under the action of enzymes. Acetaldehyde is a strong carcinogen. Alcohol is especially harmful for women, as it stimulates the production of estrogens - hormones that affect the growth of breast tissue. Excess estrogen leads to the formation of breast tumors, which means that every extra sip of alcohol increases the risk of getting sick.

6.Which cabbage helps fight cancer?

Love broccoli. Vegetables not only contribute to a healthy diet, but they also help fight cancer. This is also why recommendations for healthy eating contain the rule: half of the daily diet should be vegetables and fruits. Particularly useful are cruciferous vegetables, which contain glucosinolates - substances that, when processed, acquire anti-cancer properties. These vegetables include cabbage: regular cabbage, Brussels sprouts and broccoli.

7. Red meat affects which organ cancer?

The more vegetables you eat, the less red meat you put on your plate. Research has confirmed that people who eat more than 500g of red meat per week have a higher risk of developing colorectal cancer.

8.Which of the proposed remedies protect against skin cancer?

Stock up on sunscreen! Women aged 18–36 are especially susceptible to melanoma, the most dangerous form of skin cancer. In Russia, in just 10 years, the incidence of melanoma has increased by 26%, world statistics show an even greater increase. Both tanning equipment and Sun rays. The danger can be minimized with a simple tube of sunscreen. A 2010 study in the Journal of Clinical Oncology confirmed that people who regularly apply a special cream have half the incidence of melanoma than those who neglect such cosmetics.

You need to choose a cream with a protection factor of SPF 15, apply it even in winter and even in cloudy weather (the procedure should turn into the same habit as brushing your teeth), and also not expose it to the sun's rays from 10 a.m. to 4 p.m.

9. Do you think stress affects the development of cancer?

Stress itself does not cause cancer, but it weakens the entire body and creates conditions for the development of this disease. Research has shown that constant worry alters the activity of immune cells responsible for triggering the fight-and-flight mechanism. As a result, a large amount of cortisol, monocytes and neutrophils, which are responsible for inflammatory processes, constantly circulate in the blood. And as already mentioned, chronic inflammatory processes can lead to the formation of cancer cells.

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Diet after appendicitis

Appendicitis refers to inflammation of the appendix of the cecum. Inflammation can occur for a number of reasons, especially if a person’s diet contains quite a lot of “waste” products. In this case we mean nuts, seeds, etc. After the appendicitis is removed, it is necessary to follow a certain diet, which will be discussed below.

Diet after appendectomy

What should be the diet after appendicitis removal and what can you eat? Naturally, one should exclude irritating food. In this case, we are talking directly about sour, salty and spicy foods.

You should not eat a lot of flour, especially in the first days after surgery, as this can cause the stitches to come apart. Therefore, you should listen to your doctor’s advice and do not prescribe your own nutrition; the consequences can be serious. You must not disturb the functioning of the stomach or irritate the intestines, because all this can lead to the appearance of excess weight And unpleasant consequences. This is why there should be a diet after appendicitis.

What diet after appendectomy?

Who can tell me what diet should I follow after removal of appendicitis? This issue can only be decided by the attending physician. You can't do anything on your own. Flour, sweet, salty and spicy foods should be excluded. It is advisable to eat light soups and vegetables. But even among these products there are things that should be limited. It is advisable to eat less potatoes because they contain a large amount of starch. It is forbidden to eat fish soups, borscht and okroshka. This may cause negative reaction near the intestines, in the period after removal of appendicitis. The attending physician should provide detailed recommendations. The diet after appendicitis must be followed unquestioningly.

Diet after appendicitis in adults

What should the diet be like after appendicitis in adults and are there any specific recommendations? Of course, only the attending physician can answer this question accurately. But there are certain recommendations that should be followed. So, in the first days after removal, you need to avoid foods that can cause irritation. You can’t eat flour, it contributes to excess weight. This may cause the seams to come apart. Under no circumstances should you drink alcohol. It is not recommended to eat too hot or cold food. Detailed “instructions” regarding nutrition should be given by the attending physician. It is important that the diet after appendicitis is followed.

Diet after gangrenous appendicitis

Do you know what the diet should be after gangrenous appendicitis? The first step is to eliminate irritating foods. As a first course, you should leave light soups that are full of vitamins. Fish should be excluded; it is advisable that the soup include vegetables. As for second courses, it can be any porridge except pea porridge. It is not recommended to eat potatoes, they contain increased content starch. If you sort out vegetables and fruits, then in this case you can eat everything except sour ones. No citrus fruits, cranberries, currants, etc. It is advisable to give preference to bananas, apples and pears. The attending physician should give basic recommendations. A proper diet after appendicitis helps the body recover.

Diet after appendicitis with peritonitis

Are there any special recommendations regarding nutrition or diet after appendicitis with peritonitis? In this case, everything is much more serious, so you need to follow a certain diet. It is better to eat light foods that are not capable of causing irritation and contributing to the development of excess weight. These should be light vegetable soups, but without potatoes. For main courses, it is advisable to choose porridges such as buckwheat, oatmeal and rice. Do not eat sweets, drink carbonated drinks and eat too spicy and salty food. In general, it is advisable to wait a while with this. The body is under stress, so it should not be overloaded. That is why the diet after appendicitis should be drawn up by the attending physician.

Diet after purulent appendicitis

What should be the diet after purulent appendicitis and is it necessary to follow it? Naturally, after surgery it is imperative to follow a diet. It is prohibited to compile it yourself; this issue is dealt with exclusively by the attending physician. As after any operation, a certain diet must be followed. So, no harmful products. The daily diet should include light soups and broths. Puree soups are perfect, but only without potato content. It is advisable that they include carrots, onions, zucchini and beets. Pea puree should be excluded as it can irritate the intestines. In general, the diet after appendicitis should be properly designed.

Diet after appendicitis in children

Is there a specific diet after appendicitis in children? There are no special recommendations in this case. This means that there is definitely no difference between children and adults. Basically, the diet should be the same. But naturally, adults should give up their bad habits. As for children, it is advisable to limit the consumption of sweets so as not to further irritate the intestines. In general, the recommendations are similar; you should not eat spicy, starchy, sweet or salty foods. Include in your diet as many healthy and light soups as possible, as well as fruits and vegetables. The fact is that diet after appendicitis is the main component of the rehabilitation process.

Diet recipes after appendicitis

Do you know any recipes for a diet after appendicitis? There is no need to create something special. The diet should be familiar, but without fatty meat and fish. Carbonated drinks and sugary foods should be excluded. If we are talking about soups, then they should contain only healthy ingredients. These include carrots, beets, zucchini, peppers and onions. You should wait a bit with potatoes; a high starch content can have a detrimental effect on a recovering body. If we are talking about main courses, then it is advisable to give preference to porridge, but exclude peas. In fact, there are quite a lot of recipes, but only the attending physician can give his recommendations, which must be followed. A diet after appendicitis should help the body recover, and not cause harm.

Diet menu after appendicitis

What should a quality diet menu look like after appendicitis? It is compiled by the attending physician. After all, a lot depends on the situation itself. Therefore, it is worth providing generalized information and recommendations. So, you should exclude all foods that can cause intestinal irritation. You only need to eat healthy foods. After all, at this stage it is necessary to help the body, recover, and not aggravate the situation. Overall, in daily ration should include soups, cereals and fruits. It is advisable to hold off on eating meat and fish products. Exclude potatoes, sour fruits and pea puree. The remaining recommendations should be given by the attending physician. A diet after appendicitis should bring only positive results.

Diet by day after appendicitis

Is there a diet for days after appendicitis? Naturally, this exists, but such a menu is compiled only by the attending physician. It is advisable to eat little and sparse food on the first day after removal. So, light soups that do not contain meat or fish are perfect. These can be broths and vegetable soups. For the first days, it is advisable not to consume anything else. Over time, it will be possible to include porridge in the diet, but not peas. You should give up sweets until full recovery body, you should not irritate the intestines. As for drinks, these may not be sour juices and tea. It is advisable to exclude coffee and other things; there should not be any harmful products. The diet after appendicitis is prepared by day by the attending physician.

vermiform segment and a typical clinical picture, which makes it possible to differentiate it from other forms of the inflammatory process directly in the appendix. Most often, it is acute and provokes quite serious health consequences. That is why it is so important to promptly seek help from a doctor who will determine the causes of the pathological process and prescribe therapy.

General information

The main reasons for the development of pathology

Experts consider the following to be the main causes of this pathology:

Elderly age.
Formation of blood clots.
Atherosclerosis of intestinal arteries.

All these factors indicate that the immediate causes of the development of pathology are so-called microcirculatory disorders. Their result is considered to be a violation of normal blood circulation, as a result - necrosis of the appendix. Other elements of pathogenesis (infection, autoaggression of immune cells) are added only secondarily, only aggravating the course of the pathology.

What signs indicate pathology?

The patient's tongue is dry with a characteristic yellowish coating. In the case of primary gangrenous, the following may differ slightly:

Painful discomfort in the right iliac region, which suddenly appears and quickly subsides.
painful.
The patient's condition is assessed as serious.

If a person does not receive adequate and timely treatment, after this form of the disease gangrenous-perforated appendicitis develops. The pathology is characterized by perforation of the wall of the appendix itself. During the period of its immediate rupture, a person experiences severe pain, which over time begins to gradually spread throughout the entire abdomen. Due to increasing intoxication of the body, the temperature rises and obvious tachycardia appears. The tongue becomes very dry, the coating acquires a brownish tint. The patient suffers from severe vomiting.

Diagnostic measures

If you experience any of the above symptoms, you should immediately seek help from a doctor. If this pathology is suspected, the specialist initially conducts a physical examination of the patient. On palpation, as a rule, tension in the abdominal wall is observed, and the abdomen is moderately distended. A series of laboratory tests are then ordered, including blood and urine tests. Additionally, an x-ray and computed tomography may be required. Based on the test results, the doctor can confirm the diagnosis of gangrenous appendicitis.

Treatment methods

Therapy involves surgical removal of the appendix. Appendectomy is performed traditionally or through laparoscopy.

In the first case, the doctor removes the appendix through an incision in the abdominal wall. Typically, this procedure is performed using general anesthesia.

Postoperative period

The postoperative period in patients with such a fairly common diagnosis has a number of features:

The use of antibacterial and painkillers.
Infusion detoxification therapy using saline solutions, Refortan, glucose and albumin.
Daily blood tests.
Prevention of ulcers and thromboembolic complications. In the postoperative period, patients are prescribed gastric secretion blockers (Kvamatel, Omez) and anticoagulants (Clexane).
Daily dressings and washing of wounds.
Exercise therapy, special massage, breathing exercises.

Appendicitis surgery is a fairly serious surgical procedure. To prevent the development of complications in the future, you should use the recommendations below.

Let's talk about nutrition

This pathology is characterized by problems with nutrition; therefore, after surgery, special attention should be paid to nutrition.

On the first day, you are allowed to consume low-fat kefir, mineral water without gases and light chicken broth. On the second day, if the postoperative period is not complicated by negative consequences, you can add mashed potatoes, liquid porridge with water and cottage cheese casserole to the diet. Every other day, food needs to be varied as part of diet No. 5. It is better to avoid fatty, spicy foods and smoked foods.

Possible complications

This pathology is considered very dangerous, as it can lead to the development of complications quite dangerous to health. This process is especially critical for young patients.

What negative consequences can be accompanied by gangrenous appendicitis?

Purulent peritonitis. This is a rather dangerous condition that requires immediate surgical intervention. If help is not provided promptly, blood poisoning may occur.
Appendicular infiltrate. In the area of the inflamed appendix, a local conglomerate gradually forms, consisting mainly of organs and tissues. This problem always requires long-term conservative therapy.
Septic thrombophlebitis. The inflammatory process develops in the venous walls. As a result, it leads to the formation of blood clots in the lumen of the vein.
Local purulent abscess. Such formations predominantly develop in the diaphragm area.

Gangrenous appendicitis is the most dangerous form of inflammatory process in the cecal appendage. During this form of the disease, tissue death of the affected organ occurs. The process of death can affect both part of the appendix and the entire appendix. The danger of the disease lies in the fact that it almost always leads to the development of life-threatening consequences for the patient.

The main reason for its formation is the untimely request of a person with acute appendicitis for qualified help. The development of this form of the disease occurs approximately two days from the onset of inflammation. Apart from this, there are several other predisposing factors.

Gangrenous appendicitis does not have specific symptoms, so it can be very difficult to make a correct diagnosis. In most cases, patients experience nausea, fever and vomiting.

When determining the diagnosis, the doctor is based on the indications of a physical examination and laboratory and instrumental examinations. The presence of this form of appendicitis is an indication for immediate surgical intervention. In the postoperative period, medication and diet are indicated.

Etiology

The formation of gangrenous appendicitis is preceded by a phlegmonous stage of development of inflammation of the appendix, during which purulent contents permeate all the tissues of this organ and lead to disruption of the structure of its walls.

The main reason for the appearance of necrotic processes in diseases of the appendix is ignoring the symptoms of appendicitis throughout three days. However, under the influence of certain factors, acute gangrenous appendicitis may form earlier specified period. These reasons include:

the patient has autoimmune processes;
the course of an infectious disease;
disruption of the outflow of contents from the appendix, i.e. blockage of its entrance.

In addition, there are several primary predisposing factors for the appearance of gangrenous appendicitis. Among them:

the elderly age of the patient - in this case, a process of disruption of the blood supply to internal organs occurs;
the formation of a blood clot or other damage to the veins that supply blood to the appendix;
the development of atherosclerosis is a condition during which the formation of cholesterol plaques on the walls blood vessels;
congenital arterial hypoplasia is a congenital narrowing of the lumen of blood vessels. In such situations, the gangrenous form of appendicitis may appear in childhood.

The result of circulatory disorders in the appendage of the cecum is tissue necrosis of this organ or gangrene. During an operation to remove the appendix, doctors discover a purulent effusion with an unpleasant odor; the appendix has a greenish tint and is significantly increased in size. In this case, areas of necrosis and hemorrhage are clearly visible. Often, with a complicated course, the formation of a gangrenous-perforated type of appendicitis is observed.

With such a disease in pathological process tissues of nearby organs are actively involved.

Symptoms

This disease does not have specific clinical manifestations; the symptoms that appear cannot clearly indicate the course of gangrenous appendicitis, and this greatly complicates the establishment of the correct diagnosis.

A characteristic feature of this form of inflammation of the appendix is the absence pain syndrome, which is considered the main manifestation of appendicitis. This is due to the fact that in the process of necrosis, the nerve endings responsible for the expression die pain.

Symptoms may include:

nausea and vomiting. Vomiting can be one-time or frequent, but in any case it does not bring relief to the patient’s condition;
severe weakness of the body;
an increase in body temperature, but in some cases it may remain within normal limits;
abdominal muscle tension;
cold sweat;
lack of intestinal peristalsis and stool discharge is the main sign of gangrenous-perforated appendicitis;
the appearance of a white or yellowish coating on the tongue;
dry mouth;
chills;
increase in frequency heart rate on the background normal values temperature.

Quite rarely, gangrenous appendicitis occurs in children, and its detection is much more difficult than in adults. This is explained by the fact that the signs are blurred, and the process of necrosis occurs much faster than in patients of the older age group. The following symptoms by themselves are not able to indicate a gangrenous form of the inflammatory process, but should be an impetus for seeking qualified help. Suspicion of appendicitis is caused by:

the appearance of pain below the navel when pressing on the abdomen;
lethargy and decreased activity of the child;
increase in body temperature;
reduction or complete absence appetite;
muscle tension in the right iliac region;
causeless crying and restlessness of the child;
bowel dysfunction in the form of diarrhea;
forced body position - lying on the right side with legs tucked to the stomach.

Diagnostics

Establishing the correct diagnosis can be quite difficult, for the reason that gangrenous appendicitis, in most cases, is a secondary disease. It is because of this that it is necessary to carry out a whole range of diagnostic measures.

Primary diagnosis includes:

performing a detailed survey of the patient regarding the time of onset and degree of intensity of symptom expression;
a doctor’s examination of the patient’s medical history and life history to identify the sources of the disease;
conducting a physical examination with mandatory palpation of the abdomen.

The second step in establishing the correct diagnosis is conducting a laboratory examination:

general and biochemical analysis blood - to detect an increased level of leukocytes, an increase in ESR and acute phase indicators;
general urine test - to detect the presence of leukocytes and red blood cells, which should not normally be present;
coprogram.

The last stage of diagnosis is instrumental examination of the patient, which involves performing:

Ultrasound of the abdominal organs will provide information about the shape and condition of the appendix. The information content of such a procedure is reduced in the gangrenous-perforated form of the disease. This is due to the fact that the purulent contents of the appendix have penetrated into the peritoneum, causing its contours to be blurred;
radiography and CT - to obtain more accurate information about the cecal appendage;
diagnostic laparoscopy is a procedure that is performed using endoscopic instruments to examine inner surface gastrointestinal organs. It indicates thickening of the appendix, its greenish tint and tissue necrosis.

Treatment

Confirmation of the diagnosis of gangrenous appendicitis is an indication for immediate surgical intervention - appendectomy. The operation can be:

abdominal - the process is removed through an incision in the abdomen. In cases where the contents of the appendix enter the peritoneum, lavage and drainage are performed;
transluminal - excision of the affected organ is carried out through natural openings using special flexible instruments. Despite the fact that the intervention is performed without incisions and sutures, it is used quite rarely;
Laparoscopic is the most common type of operation. Surgical and endoscopic instruments with a light source and a miniature video camera at the end are inserted through several small incisions in the abdomen.

The postoperative period is very important in the patient's recovery. During this time, patients need to:

follow a diet;
accept medications;
perform therapeutic and breathing exercises;
use traditional medicine recipes.

Taking medications is aimed at:

anesthesia;
elimination of pathogenic bacteria;
elimination of toxic substances;
preventing the development of complications.

Diet principles:

frequent and small meals;
complete exclusion of products that cause increased gas formation;
cooking food only by boiling and steaming, stewing and baking food components;
eating only warm food, it should in no case be very cold or excessively hot;
drink enough liquid - at least two liters per day.

Besides, good results can be achieved through the use of traditional medicine recipes, but only in cases of their complex use with other methods postoperative recovery. The most effective ingredients are:

chamomile;
calendula;
rose hip;
ginger root.

Complications

Since this disease does not have specific symptoms, and diagnosis and treatment are not carried out immediately after the first signs appear, then quite often gangrenous appendicitis has a complicated course. The consequences of the disease include:

perforation of the appendix;
peritonitis;
internal hemorrhages;
intestinal obstruction;
formation of abscesses and fistulas;
portal vein thrombosis.

Postoperative complications may include wound suppuration and suture dehiscence.

Prevention

Specific preventive measures from the appearance of such a disease are - timely elimination of acute appendicitis and other etiological factors, as well as regular medical examinations.

In the case of uncomplicated gangrenous appendicitis, the prognosis will be favorable, provided that adequate treatment is provided and the patient follows all the recommendations of the attending physician in the postoperative period.

The prognosis worsens significantly with the development of complications that can lead to death.