Symptoms of Sitkovsky and Kocher with acute appendicitis: description, causes and consequences

Appendicitis - quite dangerous with itsconsequences of the disease. Therefore, the main task of a specialist is to diagnose him as quickly and correctly as possible. They help to recognize the disease a number of signs, named for the researchers who first identified them - the symptoms of Rowing, Sitkovsky, Bartome-Mikhelson, Voskresensky, and so on. Let's get acquainted with them in more detail.

Causes of appendicitis

The causes of appendicitis are several:

• Blocking the entrance to the vermiform end of the straight lineguts are the most common. This can happen because of foreign bodies, feces. Occlusion can also occur from the compression of the upper part of the appendix by the formation of adhesive processes with enteritis and cholecystitis.
• Congestion of the contents of the appendage.This leads to a weakening of its protective functions, why the appetite begins to actively multiply pathogenic bacteria - staphylococci, E. coli, streptococci. They cause inflammation.
• Spasm of blood vessels that supply blood to the appendix.
• Injury of the peritoneum, which can lead to the movement or damage of the appendix.
• Pregnancy. The outgrowth may shift because of the growth of the uterus.
• Propensity to constipation.
• Poor intestinal peristalsis.
• Binge eating.
• Lack of vegetable fibers, microelements, vitamins in the diet.
• Diseases of the digestive tract.
• Hereditary factors.
• Infectious diseases.
• Presence of parasites.
• Bad habits.
• Stress.

About the diagnosis of appendicitis in Russia

Appendicitis - inflammation of the appendixrectum. For primary diagnosis, confirmation or refutation of the diagnosis, physicians in Russia use certain symptoms of irritation of the peritoneum that have been checked for years. They are few, but they are reliable "old-timers" in clinical practice. Named after the name of their author:

• Symptom Sitkovsky.
• Symptom of Kocher.
• A symptom of Voskresensky.
• Symptom Obraztsova.
• Symptom of the Rowing.
• Symptom of Shchetkin-Blumberg.

The manifestation of each of them depends on a number of factors: the location of the appendix, the cause of the development of inflammation, the neglect of the disease, and so on. We will analyze the symptom Sitkovsky and others in more detail.

Kocher's Symptom

The most reliable sign by which you canTo determine acute appendicitis is Kocher's syndrome. Among doctors even there is an expression: "Koher does not lie". At half of patients, suffering from an appendicitis, this attribute is revealed.

It appears in the following:Pain from the epigastric region gradually migrates to the right anoroid. It is determined when collecting anamnesis, questioning the patient - clarifying the place of occurrence of the pain syndrome, its character.

Symptom Sitkovsky

With appendicitis, physicians still prefer this symptom in overwhelming numbers. The main reason is that it can be checked quickly and easily.

The manipulations are the following:The patient is asked to lie on his left side and describe his feelings. With this movement, the intestinal loops move, carrying the inflamed process behind them. Therefore, the patient with appendicitis will inevitably complain about the intensification of the pain syndrome.

Symptom of the Resurrection

Another name is "a symptom of a shirt".The symptom helps to diagnose not only appendicitis, but also other inflammatory processes of the abdominal cavity. Therefore, in clinical practice, he is as popular as Sitkovski's symptom.

It is checked as follows:on a slightly stretched shirt, which is worn on the patient, quickly spend the edge of the palm on several areas in the abdomen. If, during these actions, the patient feels pain in the right iliac region, then he can diagnose appendicitis.

Symptom of Shchetkin-Blumberg

Another sign of irritation of the peritoneum, not inferior to the familiarity of the symptom Sitkovsky. It is considered a valid test for peritonitis, which is used for all complaints of abdominal pain.

You must perform the following actions:the doctor slowly puts his hand on the front abdominal wall of the patient and gently, without pressure, presses. Then he abruptly removes his hand. If the patient felt a sharp pain, the symptom of Shchetkin-Blumberg was confirmed. In the acute form of appendicitis, the patient will feel pain during this time in the iliac right region.

The sign of the Rowing

It is rarely used in practice, which is notabolishes his fidelity, why the literature constantly mentions the symptoms of Rowing and Sitkovsky. It is determined when there is a pain syndrome with the accumulation of gases in the rectum.

The doctor conducts the following manipulations:It is necessary to squeeze the patient's descending colon in the left ileal part of the peritoneum with the lying patient. Right hand while doing a little higher jerky pressure. If, with such a change in pressure in the intestinal tract, the patient feels pain in the ileal right region, then he is diagnosed with appendicitis.

Symptom Obraztsova

After we talked about the symptoms of Rowing, Sitkovsky, Voskresensky, it would not be superfluous to tell about Obraztsov's symptom, which helps to reveal the retroticicular location of the appendix.

The patient is asked to lie on his back and raisestraightened in the knee right leg. At this time, the musculature of the anterior abdominal cavity and lower back is strained and begins to affect the receptors of the appendix. If the latter is inflamed, the patient will complain of pain in the right ileal region.

Other symptomatology

We have analyzed a number of appendicular symptoms,a symptom of Sitkovsky. Let's get acquainted with less common, but taking place in medical practice ways of diagnosing acute inflammation of the appendix:

• Symptom of Bartome-Michelson. The patient lies on the left side, and the doctor, palpating the right side of the peritoneum, finds a painful place.
• Varlamov's symptom. When tapping in the region of the right XII rib there is pain in the characteristic right side of the peritoneum.
• The symptom of Ben-Asher. The doctor presses two fingers with his tipsleft hypochondrium of the patient. The patient is asked to breathe deeply or cough. If there is pain in the right ileal region during this manipulation, there is a suspicion of appendicitis.
• Symptom of Asaturyan. The doctor pushes the right hand to the left iliac region of the patient. On the right hand area with a free hand, a specialist palpates the cecum to localize the pain sensation.
• Bassler's symptom. Soreness is determined by pressing between the upper anterior head of the ilium and the navel toward the bone of this bone.
• Symptom Iliescu. Soreness in the characteristic zone occurs when pressure is applied to the cervical point of the right diffractive nerve.
• Brando's symptom. It is used in the diagnosis of appendicitis in pregnant women. When pressing on the left rib of the uterus, pain occurs in the right region of the peritoneum.
• Zatler's syndrome. The patient in sitting position is asked to straighten his right leg. When the appendix is ​​inflamed, the patient will feel pain in the right iliac region.
• Symptom Cope. When the right thigh rotates, the pain sensation in the right ileal zone increases.

Consequences of acute appendicitis

Complications of appendicitis are divided into two groups:

• Preoperative. Their reasons:
  
  • The patient held out with a request for medical help.
  • The attending physician incorrectly diagnosed.
  • The operation was carried out with errors.
  • Inflammation has given rise to new diseases or chronic development.
• Postoperative. Their reasons:
  
  • Non-compliance with the doctor's recommendations after surgery.
  • Inflammation of the operating wound.
  • Inflammation of nearby organs, peritoneum.

Thus, appendicitis is not the most dangerous inflammatory process, which can be easily eliminated by surgery. The following complications are terrible:

• Perforation is an early type of complication developing with a peritonitis. Characterized as a purulent melting of the walls of the appendix and pus flow into the abdominal cavity.
• Appendicular infiltration - develops in patients who later applied for help. This is the spread of inflammation from the process to the adjacent organs.
• Appendicular abscess is a rare form of complication. This is a purulent inflammation in the right abdominal area, between the loops of the intestine, under the diaphragm, in the retroperitoneal space.
• Pileflebit - a severe purulent-septic inflammation of the portal vein of the liver, in which a lot of abscesses are formed. Danger of death.
• Peritonitis is an inflammation of the peritoneum.
• Intestinal fistulas are the result of mistakes in the operation. This is an accidental lesion of the intestinal loops when the appendix is ​​removed.

We disassembled, at what disease is observeda symptom of Sitkovsky, Obraztsov, Voskresensky, and so on. As you can see, with the help of diagnostic data you can easily and quickly determine the patient's appendicitis.