Intestinal abscess
Introduction
Introduction to intestinal abscess Interboweabscess (interbowelabscess) refers to an abscess surrounded by pus in the intestine, between the mesentery and the omentum. Abscess may be single-shot, or may be multiple abscesses of varying sizes, such as extensive adhesions around the abscess, can occur with varying degrees of adhesive intestinal obstruction, patients with symptoms of suppurative infection, and abdominal distension, abdominal pain, abdominal tenderness or and mass. basic knowledge The proportion of illness: 0.025% Susceptible people: no specific population Mode of infection: non-infectious Complications: intestinal obstruction
Cause
Cause of intestinal abscess
The pus is enclosed in the intestine, between the mesentery and the omentum, and can form single or multiple abscesses of varying sizes. Due to the extensive adhesion around the abscess, there are often varying degrees of adhesive intestinal obstruction, such as abscess penetration. Intestinal or bladder, the internal hemorrhoids are formed, and the pus is discharged with the urine.
Wet cold (30%):
Cold and wet sounds read hánsh. It is also a disease. Chinese medicine believes that cold and wet includes two aspects: exogenous cold and dampness and endogenous cold and dampness. Exogenous cold and dampness: exogenous cold and dampness, qi and blood operation blocked, joint and bone pain as common syndrome; endogenous cold and dampness: cold and dampness and damage to spleen, or spleen and kidney yang and cold and wet stop With chills and cold limbs, abdominal pain, diarrhea, or edema as a syndrome of common diseases.Enteritis (20%):
Enteritis is intestinal inflammation and colitis caused by bacteria, viruses, fungi, and parasites. Clinical manifestations include abdominal pain, diarrhea, septic flushing or mucus pus and blood. Some patients may have fever and sensation after urgency, so it is also known as infectious diarrhea. Enteritis is divided into acute and chronic according to the length of the disease. The course of chronic enteritis is generally more than two months. Clinically common are chronic bacterial dysentery, chronic amoebic dysentery, schistosomiasis, non-specific ulcerative colitis and limited enteritis.Long-term intestinal moist heat (10%):
Gastro-intestinal damp-heat disease starts suddenly, nausea frequently occurs, vomiting and swallowing acid, abdominal pain, urgency, and urgency, it will be uncomfortable, fecal color yellow brown and stinky, thirsty to drink, upset, short urine, less yellow, greasy tongue, veins Confusion number or slip number.Prevention
Intestinal abscess prevention
Precautions:
1. Patients with peritonitis should take a semi-sitting position to drain the peritoneal exudate to the pelvic cavity.
2. Abdominal trauma, should be thoroughly flushed abdominal cavity, as much as possible to absorb abdominal peritoneal exudate, pus and rinse, etc., after surgery is stable, should be used in the early half-sitting position.
The disease is mainly caused by abdominal infection or leakage of the digestive tract surrounded by the intestine, mesentery, abdominal wall and omentum, forming single or multiple abscesses of different sizes. Therefore, the key to prevention of this disease is active treatment of peritoneal inflammation.
Complication
Intestinal abscess complications Complications, intestinal obstruction
1. Intestinal obstruction: In the case of intestinal abscess, the wall of the abscess can form a wide-ranging inflammatory adhesion with the intestinal wall, which can lead to adhesive intestinal obstruction.
2. Internal hemorrhoids: The abscess can be inserted into the intestine or the bladder to form intestinal fistula or bladder spasm. The pus is discharged with the urine.
Symptom
Symptoms of intestinal abscess Common symptoms Aversion, low heat, weak abscess, bowel, peritonitis, abdominal pain, high heat, intense abdominal tenderness
Clinically, there may be a block of heat, abdominal abdomen, or incomplete intestinal obstruction, sometimes licking and tenderness.
1. Abdominal pain persists in pain, or there is paroxysmal aggravation.
2. The course of weight loss is longer, and it is getting thinner and weaker, with high fever or low fever.
3. Physical examination has tenderness in the abdomen, but there is no fixed point. The tender part is mostly the part where the abscess is located. There is no muscle tension, and the bowel sounds are hyperthyroidism or weakened.
Examine
Examination of intestinal abscess
Laboratory inspection
1. White blood cell count and differential count: The total number of white blood cells and neutrophils were significantly increased.
2. Red blood cells and hemoglobin: Red blood cells and blood proteins may be reduced in patients with long-term or weakened disease.
Film degree exam
1. B-ultrasound: There are multiple liquid dark areas in the abdomen to help diagnose.
2. X-ray examination: found that the distance between the intestinal wall widened and local intestinal sputum accumulation.
3. CT examination: multiple abscesses of different sizes can be found in the abdomen.
Diagnosis
Diagnosis and identification of intestinal abscess
diagnosis
1. History: Most patients have a history of acute diffuse peritonitis or abdominal trauma.
2. Clinical features: In addition to signs of peritoneal inflammation, there are symptoms of incomplete intestinal obstruction, superficial or large abscess can touch the tender mass in the abdominal wall.
3. Auxiliary examination: support the presence of intestinal abscess, such as the increase in the total number of white blood cells and neutrophils; X-ray examination showed widening of intestinal spacing, local accumulation of effusion; B-ultrasound found single or multiple abscesses.
Differential diagnosis
First, underarm abscess
Any place where pus accumulates under the diaphragm is called an underarm abscess. Underarm abscess is the most important type of abdominal abscess. It is a serious complication of peritonitis. When the infection forms an abscess under the armpit, it must pass. Surgical drainage can be treated.
The inferior peritoneal lymphatic network is rich, so the infection is easy to lead to the underarm. The underarm abscess can be caused by infection in any part of the body. Most of them are complications of abdominal purulent infection, which is common in acute appendicitis perforation. Intestinal ulcer perforation, as well as acute inflammation of the liver and gallbladder, these often complicated right axillary infection, extraperitoneal axillary abscess, mostly from the liver abscess, according to statistics, about 25 to 30% of the underarm infection will develop into an abscess, The rest can dissipate on its own, which is due to the strong resistance of the peritoneum in the upper part of the abdominal cavity.
Most of the pathogens causing abscesses are from the gastrointestinal tract. E. coli, anaerobic infections account for about 40%, streptococcus infections account for 40%, and staphylococcal infections account for about 20%, but most are mixed infections.
Second, pelvic abscess
The pelvic cavity is located at the lowest part of the peritoneum, and the inflammatory exudate in the abdominal cavity is easy to accumulate here, which is the most common complication of intra-abdominal infection.
