SURGICAL DISEASES, TRAUMATOLOGY, ORTHOPEDICS, UROLOGY : CHECK IT OUT HERE (INTRODUCTION) GUTS (INVAGINATIO INTESTINORUM) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Etiology. The introduction begins in the region of localization of the legs of the polyp, moving through the intestines and pull the connecting intestinal wall, or in the presence of tumor in the bowel wall its contraction, inflammatory infiltrate, spasm, especially during periods of increased peristalsis (diarrhea, coarse food).
The pathogenesis. Usually takes place downward implementation. Perhaps an independent smoothing short introductions. Localization most often is the introduction of the small intestine in a blind, much less thin in thin and just less thick in thick. A simple implementation consists of three tubes: the outer vagina or case, middle and inner - invaginate. Rare multi-cylinder intussusception of five and seven walls.
Symptoms. The acute form. General effects: thirst, decrease in amount of urine, effects of heavy collapse, normal temperature. Local effects: acute, rapid onset, sudden cramping pain, enhanced motility when listening (sometimes visible through the abdominal integuments),bloating (impermanent), vomiting, delayed stool, then liquid stool with admixture of mucus and blood, tenesmus, gaping anus in the study of the rectum. When feeling a cylindrical or Kolbasna elastic tumor in the abdominal cavity, are little painful, movable. Infants suddenly start to scream and writhe in pain, pale, no longer breastfeed, they have vomiting, abdomen soft, first palpable tumor masquerading then swelling, chair of pure blood or liquid stool with mucus and blood clots. In subacute and chronic form (usually in adults) General symptoms are not expressed. Possibly fever (inflammation in invaginate). The weight loss. Local symptoms: acute alternating with remission. Appear diarrhea with mucus and blood. The tumor increases. Research through the rectum sometimes allows you to feel the lump, not defined through the abdominal wall.
For. With wide lumen at the site of intussusception (ileocecal intussusception in adults) obstruction of long-term does not occur, the disease is chronic. In severe cases, comes obstruction, compression of the mesentery of invaginata, edema, circulatory disorder, necrosis and the development of peritonitis. When self-smoothing can be re-intussusception (intermittent).
Recognition is easy when there are major signs: abdominal pain, symptoms of obstruction, Kolbasna swelling, secretion from the intestine to the blood. Possible confusion with an acute attack of appendicitis (fever, stool retention, painful, not elastic infiltration) and hemorrhagic colitis (less rapid onset, fever, no symptoms of obstruction and tumor). In chronic and doubtful cases, the characteristic x-ray picture, especially during the filling of the bowel barium via enema (ileocecal and colonic intussusception).
Early emergency surgery. Attempts at conservative treatment is contraindicated.