The blind gut (Coecum) lit but the about eight centimeters long vermiform appendix isn't at a typhlitis. It is a small appendix thing of the blind gut. The blind gut is at the transition of this thinly to the large intestine. The appendix has only an orifice but no exit and contains many lymph nodes. Among other things these anatomical condi-tions explain its inflammation tendency.
A typhlitis (Appendicitis) can happen in every age, 70 per cent of the persons af-fected, however, fall ill between the 5th and 30th years of life with a frequency maxi-mum between 10th and 15th years of life. With children among two years the "ap-pendicitis" appears rather rarely. Boys and men suffer from the inflammation more frequently than girl and women.
The cause of the inflammation often cannot be cleared obviously. The infection is favored by traffic-jam of the vermiform appendix content. This happens for example at one as of kinking of the appendix. Further frequent inflammation causes are the blockage of the vermiform appendix with coproliths or intestine infections.
Since he represents a dead end virtually, dish remnants can accumulate lightly there. You also can lead to an inflammation. Rather rare reasons, rest is worm infestation (for example pinworms), foreign body (approximately cherry pits) or tumore for the illness.
The clinical picture appears as follows. At first strong stomach ache appears. The convulsive stomach ache frequently starts in the area of the navel and/or the upper abdomen and then manifests itself in the right hypogastrium. A pain increase is char-acteristic hopping on the right leg. In addition, the pains increase at the sneezing or cough. At the beginning of the illness the whole abdominal cavity is pressure-sensitive and the abdominal wall is tense. It comes to the so-called "rebound tender-ness" in the right hypogastrium hours later. The impressions and letting off of the ab-dominal wall are increased pains. The pain is suddenly no longer available after some hours and the abdomen move again, there is the suspicion of an acute perfo-ration of the vermiform appendix (see under complications). Soon, the pains in-crease, however, again.
Further symptoms of a typhlitis can be lack of appetite, nausea, greenish vomiting as well as constipation or diarrhea. These symptoms feign a gastroenteritis. Another symptom is a moderate fever to 38.5 º C. characteristic is the difference of over 1 º C between the measured temperature below the shoulders and in the rectum. The fallen ill is often very pale and has a face covered in sweat, the tongue is coated.
You should draw your physician to rate at all acute or unclear stomach ache which lasts longer than two hours. Go to your treating physician or into the next clinic im-mediately if her child quite suddenly has colicky stomach ache and puts itself on the right side spontaneously with dressed legs.
The attending doctor will proceed as follows:
The diagnosis is certain its physician will transfer her child into a hospital as quickly as possible acute typhlitis firm. The medical treatment consists most still on the same day in removing operatively (appendectomy), the vermiform appendix. The rapid behavior explains itself due to the dreaded complication of a blind gut perfora-tion (perforation) with a life-threatening peritonitis. The operation (OP) is carried out under general anesthesia, nowadays is considered a routine operation and lasts only few minutes. The surgeon puts an approximately six centimeters long, horizontal in-cision below the navel on the right side. Besides the one of conventional OP micro operations are also possible with the endoscope under general anesthesia. Proves during the endoscopic operation, out that there is a far-reaching inflammation gets made way on the classic operation method be.
- It becomes the diagnosis secure with the sensitivity to pain at the feeling ex-amination of different places (McBurney point, Lanz point, Blumberg sign > re-bound tenderness etc.) of the abdomen.
- The body temperature is measured (rectal and axillary > difference greater
- The blood is examined. Increased leukocyte values (white blood corpuscles) and further inflammation parameters suggest a possible typhlitis.
- A feeling the rectum (digito rectal examination) carefully is obligate.
- An ultrasound of the abdominal cavity can be helpful at the diagnosis harden-ing.
If the domiciliary nursing care of their child is guaranteed, then children are already dismissed after the operation a day. Your child then still should stay one until two weeks at home. It, however, doesn't have to stay in the bed. Then let your child raise nothing heavy for about four weeks. For several weeks it shouldn't do any exhausting sports.
The dreaded complication at a typhlitis is the perforation or the breakthrough of the blind gut. Defecate and pus can leave into the abdominal cavity and cause a life-threatening peritonitis (peritonitis). With girls and women such an infection also can lead to adhesions with a sterility resulting from it. There is the danger of abscesses (pus accumulations) in the abdominal cavity (for example at the liver) at a purulent typhlitis.
Due to the scar formation the intestine slings stick together at a little share (2 to 4%) of the patients after the operation. A renewed operation then can become necessary.
The prognosis, appendicitis treated at full term at one, is very good. The mortality is enclosed less than 1% at a perforation and purulent peritonitis at around 10%. Due to this data you must emphasize once again that it can the more soonly you go to your physician at troubles mentioned above diagnose and treat the more rapidly.
Another progressive form of the typhlitis is the so-called chronic (relapsing) appendi-citis. As a rule, it appears as a result of an acute typhlitis faded away. Is again and again appearing, distinctive uncharacteristic troubles in this raked hypogastrium. The attending doctor will arrange for a blood test for the determination of the inflammation parameters and a roentgen examination with contrast medium (> of this isn't visible in the appendix at a chronic inflammation) arrange. With the results the physician takes the decision at first to treat with confinement to bed conservatively or immediately to carry out an appendectomy.
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