Appendicular Infiltrate - Causes, Symptoms, Diagnosis And Treatment Of Appendicular Infiltrate

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Appendicular infiltration

Causes, symptoms and treatment of appendicular infiltrate

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What is appendicular infiltration?

Infiltration in appendicular form is an acute complication of intermediate stage appendicitis lasting up to 5 days. It is an accumulation of altered tissues of an inflamed appearance, tightly interconnected. This conglomerate includes the appendix itself and the formations adjacent to it: the small intestine, omentum, cecum. Appendicular infiltration is formed 3-4 days from the start of the disease. In this case, the right iliac region (sometimes another area) acquires a limited type of formation, dense, immobile and painful when pressed.

Symptoms of appendicular infiltration

Lack of timely surgical intervention can lead to a purulent-infiltrative process in the right iliac region, where a congestion of organs, including the appendix, is created, the tissues of which have an inflamed appearance. Observations record the presence of an appendicular abscess in 15% of patients who were operated on on the basis of a gynecological disease, and the secondary retraction of the appendix into a purulent process in the presence of a gynecological deviation, according to some data, is about 10%.

The disease begins with sudden paroxysmal pain, which is initially localized in the navel. At the same time, there is no characteristic connection between the disease and risk factors, in which inflammatory processes of the internal genital organs develop. Nevertheless, a carefully collected anamnesis initially makes it possible to establish a surgical pathology. On the fourth day after an acute attack or later, if anti-inflammatory or antibacterial treatment was used, an appendicular infiltrate is formed.

After a few days, the pain becomes less, but the intoxication of the endogenous species persists. There is a persistently elevated temperature up to 37.8 ° C with a moderate increase in heart rate and leukocytosis. By palpation, an infiltrate can be determined in the iliac region of the right side, which has a dense consistency with clearly defined boundaries. However, it can dissolve in 30-40 days, but suppuration is most likely.

In the worst case, the patient's condition rapidly deteriorates, and all symptoms of purulent inflammation appear: sharp fluctuations in body temperature, chills, increasing and sharp pain of infiltration, local fluctuation, uneven consistency.

Diagnostics of the appendicular infiltrate

Diagnosis of appendicular infiltration consists of a physical examination. Clarification of the diagnosis can be done after echography. When it is carried out in the iliac region, on the right side, an infiltrate is revealed, which has an irregular shape of an echo-positive formation without the presence of a clear capsule, it determines the presence of reduced echogenicity in relation to the adjacent tissues. The examination can reveal abscess formation of the infiltrate structure and fix cystic formations with a clear capsule and liquid contents, which indicates the accumulation of pus.

Treatment of appendicular infiltrate

Treatment of appendicular infiltrate is conservative, but should be carried out only in a hospital setting. It consists in antibacterial therapy, diet, limitation of physical activity. No surgical treatment is required. As a rule, appendicular infiltration resolves after 2 weeks of treatment.

Emergency surgery is performed only for certain indications: abscess perforation into the bladder or abdominal cavity, and septic shock. An emergency operation with the development of a purulent process has technical difficulties and may threaten the prospect of developing septic shock. Technically, the operation is the same, but in especially serious conditions, patients undergo a palliative intervention, that is, drainage of the abscess or stomy of the cecum is performed, and during the period of remission, a reconstruction operation is performed. Therefore, it is so important to timely recognize and operate the appendicular infiltrate.

A thorough collection of information about the symptoms of the disease provides the basis for an accurate diagnosis of a surgical disease even before the operation. Neglected cases, even when the womb is cut, cause difficulties in determining the root cause. This does not change the tactics of the operation; in any case, an appendectomy and a gynecological surgical intervention appropriate to the case with further drainage of the abdominal cavity are performed.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".