Overview.
Simple appendicitis is an early form of mild appendicitis or acute appendicitis with pathologic changes mostly confined to the submucosal layer and acute appendicitis with hemorrhagic spots and small ulcers on the mucosal surface. There is mild swelling of the appendix, congestion of the plasma membrane surface or a small amount of fibrin exudate. The disease can be treated nonsurgically.
Etiology
1. It is generally thought to be caused by a simple nerve reflex.
2. Obstruction and bacterial infection in the lumen of the appendix is not obvious and is not a major cause.
Symptoms
1.Symptoms
(1) Abdominal pain The disease begins with “stomach pain” for 2-6 hours, followed by metastatic right lower abdominal pain without rebound pain.
(2) Gastrointestinal symptoms: nausea, vomiting, loss of appetite, diarrhea and constipation.
(3) Systemic symptoms Most of them have no obvious systemic symptoms, but may be accompanied by fatigue and fever.
2. Physical signs
(1) Fixed pressure pain in the right lower abdomen This is the most important sign of acute appendicitis, the pressure pain site is commonly found in the Mai’s point, which may change with the variation of appendix position, but the pressure pain point is always in a fixed position. In the early stage of the disease, when the abdominal pain has not been transferred to the right lower abdomen, the pressure pain has been fixed in the right lower abdomen.
(2) Other physical signs Closure muscle test, psoas major muscle test, colonic insufflation test and rectal fingerprinting can be used as auxiliary diagnosis.
Examination
1. Laboratory examination
The white blood cell count and neutrophil ratio are increased to different degrees, and a small number of red blood cells can be found in routine urine examination.
2.Ultrasound
The appendix is a swollen tubular or finger-like structure with a thickened wall. The central appendiceal lumen is a non-echoic area, surrounded by the swollen appendiceal wall with strong (mucosal layer), weak (muscular layer) and strong (plasma layer) echogenic structures.
3. Abdominal X-ray
Appendiceal fecaliths can be found in a few patients.
Diagnosis
1. Metastatic right lower abdominal pain.
2. Limited pressure pain in the right lower abdomen.
3. Increased white blood cell count and elevated neutrophil ratio.
4. Ultrasound, X-ray and other imaging studies may also help in the diagnosis.
Treatment
Upon diagnosis, surgery should be performed immediately, while non-surgical treatment is feasible in a few cases.
1. Non-surgical treatment
Appropriate bed rest, diet control, and effective antibiotic anti-infection treatment. Intravenous supplementation of water, electrolytes and heat. Traditional Chinese medicine is mainly used to reduce inflammation and diarrhea, and physical therapy or hot compresses can be applied to the right lower abdomen to promote the absorption of inflammation and reduce pain.
2.Surgery
If the diagnosis of simple appendicitis is confirmed, the effect of non-surgical treatment is not good, the mass in the ileocecal region is formed after non-surgical treatment, and other lesions of the appendix such as tumors are combined, appendicectomy can be considered, and the incision can be sutured in stage I. Laparoscopic appendicectomy can be adopted as well.
Preventive measures
1. Strengthen exercise
One should actively participate in physical exercise to enhance physical fitness and improve immunity. Don’t do strenuous exercise such as swimming, jumping, playing ball, running, etc. immediately after meals.
2.Diet
(1) Pay attention to hygiene, eat regularly, chew and swallow slowly to reduce the food residue entering the cecum.
(2) Pay attention not to get cold and eat irregularly, do not overeat, avoid raw, cold, hard and other indigestible food.
(3) Don’t eat too much fat and avoid eating too much stimulating food.
3. Bowel movement
If you have a history of chronic appendicitis, you should pay more attention to avoid recurrence, and usually keep your bowels clear.