volvulus syndrome
Introduction
Introduction to volvulus syndrome Cervical syndrome (volvulussyndrome) refers to a group of intestinal obstruction syndrome caused by the entanglement of the terminal ileum and the sigmoid colon. It can cause intestinal circulation obstruction and partial or complete closure of the intestinal lumen to produce a closed intestinal obstruction. The intrinsic mainly occurs in middle-aged and elderly people. People over the age of 45 are the most common, and the incidence rate of males is higher than that of females. The cecal torsion and transverse colon torsion are rare. basic knowledge The proportion of illness: 0.001% Susceptible people: people who are more than 45 years old Mode of infection: non-infectious Complications: intestinal obstruction
Cause
Cause of bowel syndrome
The cause of the disease is unknown, and may have a certain relationship with the anatomical variation, that is, the terminal ileum and the sigmoid colon have an excessively long mesangial membrane, and one end thereof is firmly fixed on the posterior peritoneum, which causes a condition that the intestinal tube is easy to rotate, due to turning over The gravity of a large amount of accumulated material in the intestine can cause one intestine to wrap around another intestine, causing kinking and becoming more and more tight, and cannot be self-resetting. In severe cases, strangulated intestinal obstruction may occur. Cohn et al. The formation of volvulus must have two elements: 1 too long colon segment with its own movement in the abdominal cavity; 2 must have the intestine segment fixed point close to each other as the main focus of possible intestinal torsion, others believe that long-term constipation And poor bowel habits can be used as a cause of sigmoid torsion.
Intestinal torsion can lead to increased intestinal pressure, continuous intestinal high pressure can damage the intestinal blood circulation, which can form strangulated intestinal necrosis, 5 cases of intrinsic patients have been reported, 4 cases of intestinal necrosis were found during surgery 1 case of the intestine is brownish black. When the twisted and narrowed colon is overfilled by a large amount of gas, perforation may occur. Once strangulated obstruction occurs, in addition to loss of body fluid and plasma, toxicity from strangulated intestinal fistula Substances can be life-threatening, and after intestinal obstruction, severe metabolic disorders and water and electrolyte imbalance can occur.
Prevention
Prevention of bowel syndrome
Intestinal torsion is a period of intestinal fistula rotating along the long axis of the mesentery or twisting of the two segments of the intestine to cause a closed intestinal obstruction. The former patients have paroxysmal severe cramps in the lower abdomen, abdominal distension, defecation exhaust stops, after the middle It can cause nausea and vomiting, vomit is gastrointestinal contents, pay attention to fasting, gastrointestinal decompression, maintain water and electrolyte balance, anti-infection, and maintain nutrition.
Complication
Complications of gastrointestinal torsion syndrome Complications, intestinal obstruction
1. Cure: After conservative treatment, the reversal of intestinal fistula or the disappearance of symptoms and signs, intestinal function recovery, or surgical re-adjustment or necrotic bowel resection and anastomosis and postoperative signs and signs disappeared.
2. Improvement: Symptoms and signs basically disappeared, and most of the intestinal tract was reversed; but the intestinal function did not completely return to normal.
3. Unhealed: no improvement or aggravation of symptoms and signs after conservative treatment, or intestinal obstruction after surgery.
Symptom
Symptoms of bowel syndrome Syndrome Common symptoms Abdominal pain with nausea, vomiting, bowel, intussusception, shock, constipation, fecal impaction, fecal vomit, nausea and bloating
All patients with acute intestinal obstruction should consider the possibility of intrinsic, X-ray examination can confirm the diagnosis, but need to identify with intussusception, mechanical intestinal obstruction, fecal impaction, tumor.
Intrinsic has the clinical manifestations of general intestinal torsion and intestinal obstruction, rapid onset, rapid development, patients with paroxysmal severe cramps in the lower abdomen, abdominal distension, defecation and cessation, nausea and vomiting may occur after mid-term, vomit is gastrointestinal content If there is a strangulation, the above symptoms are aggravated, and even the necrotic perforation has symptoms and signs of diffuse peritonitis, toxic shock and fluid electrolyte imbalance.
Examine
Examination of bowel torsion syndrome
Check the abdominal bulging or intestinal type, abdominal tenderness, the lesion is the weight, percussion and auscultation with drum sound, early audible and high-pitched bowel sounds and gas over-water sound, after the mid-term bowel sounds decline or disappear, rectal examination It is often found that the stool in the ampulla of the rectum is absent, and when there is a strangulation or perforation, a peritoneal irritation sign may be present.
X-ray examination showed the sigmoid colon and small intestine hard position, which showed that the enlarged colonic sac was located in the right lower abdomen or right part, while the left abdomen was a group of large intestines.
Diagnosis
Diagnosis and differential diagnosis of intestinal torsion syndrome
Can be diagnosed based on clinical performance and laboratory tests.
All patients with acute intestinal obstruction should consider the possibility of intrinsic, X-ray examination can confirm the diagnosis, but need to identify with intussusception, mechanical intestinal obstruction, fecal impaction, tumor.
