Pain. The most important, frequent and important symptom of acute appendicitis. Most often occurs at night or in the early morning. Localization of pain in the first hours of the disease – in the epigastric region, that is, in the upper central part of the abdomen, under the sternum. There may also be vague pain throughout the abdomen. These initial pains are rarely intense, can be spastic, and subside for a while. After 2-3 hours, the so-called Kocher symptom occurs – the displacement of pain and their localization in the right iliac region – the right lower abdomen, approximately in the middle of the distance between the groin fold and the navel.
The pain described above is characteristic of the typical anatomical location of the appendix. With other variants of its location, and there are many of them (under the liver, in the small pelvis, behind the cecum, retroperitoneally, and also – in the rarest cases with situs viscerum inversus – the mirror arrangement of internal organs), pain can be noted, respectively, in the right hypochondrium, right lumbar areas above the pubis, in the right thigh, in the anus, in the left half of the abdomen. Quite varied, isn’t it?
There are a number of symptoms associated with pain in appendicitis and named after the doctors who discovered them – Rovzing, Sitkovsky, Voskresensky, Obraztsov, Cope. Some of them will be sure and will be tested on you by the surgeon on duty in the hospital emergency room. Do not be indignant and do not resist! He knows what he is doing, and you do not need to know, remember and apply these copyright symptoms on occasion on those familiar with abdominal pain.
2.Nausea and vomiting. They may not always be noted, in about 2/3 of cases. Usually, soon after the onset of the initial pain, nausea appears, and then one or two vomiting, which is rarely profuse. Vomiting is of a reflex nature as a result of irritation of the nerve endings of the peritoneum in the area of developing inflammation. If the patient does not seek help on time after 2 days from the onset of the disease, vomiting may resume, but already against the background of developing peritonitis and general intoxication of the body.
3. Increase in body temperature. In the first 12 hours at the initial stage of the inflammatory process, the body temperature is usually 37.2-37.5 degrees Celsius. In 3-7% of cases, it can reach 38 C and more in the first hours. Later, after 12 hours and up to 2 days, the temperature usually reaches febrile figures – 38 C and above, there is a feeling of heat or chills.
4. Violation of the stool. Uncommon, but loose stools may occur, 1-3 times. Occurs when the pelvic appendix and adherence to the rectum or irritation of the nerve endings of the pelvic peritoneum.
5. Frequent urination. More often observed in women, it is associated either with the above-described irritation of the pelvic peritoneum, or exposure to the bladder or the right ureter with an inflamed appendix close to it.
6. General weakness and malaise. Associated with the developing intoxication of the body.