Chronic appendicitis

Chronic appendicitis is a common disease of the digestive system, which is characterized by inflammation of the appendix of the blind part of the intestine, which is characterized by low severity of inflammation. Chronic appendicitis has a direct connection with the transferred acute appendicitis, for which no surgical intervention was performed.

The clinical picture of the chronic form of appendicitis is in many ways similar to an attack of acute appendicitis, but may differ in a different intensity. Diagnosis of the disease presents some difficulties due to similar symptoms with other diseases of the gastrointestinal tract.

At the moment, pathology is quite rare, due to the radical treatment of acute appendicitis. Often, chronic inflammation is accompanied by other unpleasant conditions – blockage of the lumen of the process, the formation of adhesions with intestinal loops and surrounding tissues, deformation of the process and its fusion.

CAUSES OF DEVELOPMENT AND CLASSIFICATION OF CHRONIC APPENDICITIS
Depending on the root cause, there are several types of chronic appendicitis:

Recurrent form
Residual form – recurrent form
Chronic primary form
The recurrent form is a special type of chronic appendicitis. In essence, with this form, the patient has periodic attacks of acute appendicitis, which pass by themselves without surgical intervention. During remission, the patient is either worried about minor, very weak clinical symptoms, or does not worry about anything at all.

The residual form differs from the recurrent one only by internal pathological processes – namely, during remission, the inflammatory process continues in the appendix with the subsequent development of concomitant aggravating circumstances.

Concomitant factors to the development of chronic appendicitis may be the following conditions:

Poor hemodynamics and circulatory disorders of the vessels supplying the loops of the intestine and appendix.
Reduction of local immunity, which promotes the reproduction of pathogenic microorganisms.
SYMPTOMS OF CHRONIC APPENDICITIS
Experts classify cases of chronic appendicitis by one more feature. Chronic appendicitis can occur in a patient who has not had surgery, as well as in those who have undergone surgery to remove the appendix (if there are remnants of the appendix.

First of all, chronic appendicitis differs from acute by a reduced intensity of symptoms, erased course. The patient complains of discomfort and pain of a dull aching nature in the right side, in the iliac region (lower abdomen on the right). The pain may be permanent, or it may occur periodically. The patient also experiences nausea or vomiting, bloating and flatulence.

The work of the intestines may be disrupted in the form of constipation or, conversely, diarrhea. Uncharacteristic and more rare clinical symptoms:

Frequent urination, which is accompanied by pain.
Pain during vaginal examination by a gynecologist.
Pain during defecation or rectal examination
DIAGNOSIS OF CHRONIC APPENDICITIS
Diagnosis of chronic inflammation may be difficult due to the ambiguity of symptoms or their absence. During examination and palpation of the patient, the following diagnostically important symptoms can be detected – a positive symptom of Sitkovsky, Obraztsov.

To make a diagnosis, an irrigoscopy, an X-ray examination, an ultrasound of the abdominal cavity, as well as basic laboratory tests are required.

TREATMENT OF CHRONIC APPENDICITIS
Surgical intervention for the removal of the appendix is carried out with persistent pain syndrome, which develops not in acute, but in the chronic course of the disease. With this type of appendicitis, surgical intervention is more difficult – after all, the further development of the disease and its consequences depend on it. Chronic appendicitis is characterized by the frequent development of the adhesive process.

With an unexpressed clinical picture, conservative treatment is carried out – the patient is prescribed anti-inflammatory drugs, physiotherapy, antispasmodics and painkillers if necessary.

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