Symptoms of chronic appendicitis

summary

Chronic appendicitis is a rare appendicitis disease. It is a chronic inflammatory disease of appendix left after acute inflammation subsides. It is divided into recurrent (intermittent) paroxysmal appendicitis and chronic (obstructive) appendicitis. The former has a clear history of acute appendicitis, then repeated, intermittent, subacute attack, because the history is clear, easy to diagnose, is one of the more easily confirmed chronic appendicitis.

Symptoms of chronic appendicitis

Recurrent (intermittent) paroxysmal appendicitis has a clear history of acute appendicitis. After that, the patients had repeated attacks intermittently, but all of them were subacute. Attacks often have reflex stomach discomfort, abdominal distension, constipation and other symptoms, more certainly for the right lower abdominal pain and local tenderness, not serious. After repeated attacks, the cord like appendix can also be found in the right lower abdomen. It is easy to identify clinically.

As for the patients without acute appendicitis, the history is not clear, and the symptoms and signs are not typical, so the diagnosis is difficult. Patients often have regular right lower abdominal colic attacks, the degree of pain is different, most of them are dull pain, usually have more gastrointestinal symptoms, such as loss of appetite, abdominal distension, stomach discomfort after eating, constipation or mild diarrhea, etc. The most common and concentrated clinical manifestation is pain and tenderness in the right lower abdomen, involving a wide range, but still centered on the appendix.

Once chronic appendicitis is diagnosed, appendectomy is still the treatment. The operation of chronic appendicitis is not only a treatment, but also a measure of final diagnosis. The diagnosis of chronic appendicitis before operation can be confirmed by finding that the appendix is thickened, the mesentery is shortened and hardened, the appendix is twisted and the adhesion around it is serious.

matters needing attention

Although some people think that the pathology of chronic appendicitis is sometimes uncertain, most of them still have definite changes. The wall of appendix is hypertrophic, fibrotic, thick, short and tough. The surface is gray. The mesangium of appendix is thickened, shortened and hardened. There are lymphocytes and eosinophils infiltrating around blood vessels in mucosa or under serosa. In some cases, foreign body giant cells can be seen.