Intestinal balloon cyst
Introduction
Introduction to intestinal balloon disease Intestinal air sac is a rare disease in which there are many air sacs in the submucosal or serosal membrane of the intestine. The balloon swelling is most common in the small intestine, especially the ileum, followed by the colon and other parts of the body. The disease can occur at any age, more common between 30 and 50 years old, more men than women, about three times as many as women, 85% of intestinal cysts are secondary to ulcers combined with pyloric obstruction, inflammatory bowel disease, Gastrointestinal tumors and chronic intestinal obstruction basic knowledge The proportion of illness: 0.0035% Susceptible people: no specific population Mode of infection: non-infectious Complications: gastrointestinal bleeding, intestinal obstruction, volvulus
Cause
Causes of intestinal balloon disease
The cause of the disease is still unclear. Some authors believe that when the gastrointestinal mucosa is damaged, the intestinal gas can enter the intestinal wall from the damaged area. In patients with chronic obstructive pulmonary disease, the gas may enter the mediastinum from the ruptured alveoli. Along the aorta and mesenteric vessels to the mesentery, gastrointestinal ligament and submucosal submucosal, some authors believe that intestinal balloon tumors are formed by bacterial infections in the lymphatics of the intestinal wall, and some authors believe that lack of certain foods in malnourished foods Some substances or carbohydrate metabolic disorders lead to an increase in acidic products in the intestinal lumen, which may increase the permeability of the intestinal mucosa. The acidic product combines with the alkaline carbonate in the lymphatics of the intestinal wall to produce carbon dioxide gas, which is exchanged with nitrogen in the blood. A gas cyst is formed.
If the intestinal air sac is related to peptic ulcer and pyloric obstruction, the air sac is located in the empty and ileum; if it is related to the lung disease, except for the mesenteric liver and stomach ligament, it mainly gathers in the ileocecal area, such as after the colonoscopy. It is concentrated in the colon, and it is similar to soapy or lymphoma-like in the subserosal. It can be scattered or clustered, ranging in size from a few millimeters to centimeters. The appearance of the submucosal is not easy to see, and the affected bowel is palpated. Like a sponge, the intestinal wall has a honeycomb section, the cyst wall is thin, and the lining is a single layer of flat or cubic epithelial cells, which seems to conform to the dilated lymphatic vessels. The cyst contains gas, which does not communicate with each other, and the oxygen content of the gas components. Less, may be related to absorption, and the rest is similar to air.
Prevention
Intestinal balloon disease prevention
Under today's living conditions, it is not advisable to over-emphasize high-sugar, high-protein, high-vitamin and low-fat diets. However, the nutrition should be balanced, and the vegetarian diet should be accompanied by vegetables, fruits, meat, egg milk, etc. The intake is determined by the fatness of the person.
Complication
Intestinal cystitis complications Complications, digestive tract, intestinal obstruction, intestinal torsion
Can cause gastrointestinal bleeding, intestinal obstruction, intestinal torsion, pneumoperitoneum and other complications.
Symptom
Intestinal air sac swelling symptoms Common symptoms intestinal wall necrosis immunodeficiency malabsorption syndrome constipation diarrhea blood intestines nested intestinal paralysis cyst peritoneal irritation
The disease is rare, and clinical diagnosis is rarely made. For patients with faint discomfort in the abdomen, if there is free gas in the abdomen and there is no peritonitis under the axilla, the possibility of the disease should be considered. The diagnosis mainly depends on the X-ray. With endoscope.
The disease can occur at any age, more common between 30 and 50 years old, more men than women, about three times as many as women, 85% of intestinal cysts are secondary to ulcers combined with pyloric obstruction, inflammatory bowel disease, Gastrointestinal tumors and chronic intestinal obstruction, etc., the symptoms are mainly the manifestations of the primary disease, a small number of people without other gastrointestinal diseases called "primary" intestinal cystitis, most of the disease occurs in a certain period of time Symptoms, such as episodes of diarrhea last for several days or weeks, stools contain a lot of mucus and air bubbles, abdominal pain with constipation or thin stools, blood in the stool is not uncommon, such as intestinal emphysema in the small intestine and extensive, can occur malabsorption syndrome, Intestinal palsy, intussusception or intestinal torsion may occur, and the balloon may sometimes rupture by itself and cause pneumoperitoneum without accompanying peritonitis. Occasionally, the disease may cause peritoneal adhesions, and submucosal cysts block the intestinal lumen and cause intestinal obstruction.
The fulminant intestinal cystitis often occurs in acute intestinal infections and intestinal wall necrosis. This patient often has autoimmune defects, and the clinical manifestations have obvious symptoms of poisoning and peritoneal irritation.
Examine
Examination of intestinal airway swelling
1. X-ray inspection
Abdominal plain film
Take the flat position and the upright position, and clean the enema before the filming. When the airbag is small and the quantity is small, there is no characteristic performance. If the airbag is large and large, especially under the serosa, it can be seen:
1 The edge of the inflated bowel can be seen as a clustered or wavy continuous sac-like light-transmissive area, ranging in size from miliary to grape-sized, usually 1 to 2 cm in diameter;
2 When the airbag ruptures to form the pneumoperitoneum, the standing piece can see the free gas under the armpit;
The Chiralditi is a gas-to-belly volume between the diaphragm and the liver or the fundus, which causes the sputum to rise, the liver or the fundus to descend, causing a considerable gap, and the inflated bowel tends to rise. Entering the gap, the formation of meta-intestinal curvature, the intestinal tract of the balloon swelling is more likely to form a meta-position, so that the sac-like translucent area of the intestinal wall is more clear, and this sign appears to be of great help in the diagnosis of the disease.
2. X-ray meal
It can further clarify the discovery of the plain film and affirm the distribution and extent of the balloon swelling. It often has the following manifestations: there are saclike translucent areas of different sizes at the edge of the filling lumen, such as the balloon under the serosa, the light transmissive zone often Located at the outer edge of the contour of the intestine, if the balloon protrudes into the lumen of the intestine, a translucent polypoid filling defect can be seen at the edge of the intestine, which must be noted with polyps and neoplastic filling defects.
2. Fiber endoscopy
When the endoscopic examination of the colonic balloon is seen, there are circular bulges of different sizes under the mucosa. The mucosal surface is smooth and complete, the base is wide, and there is no stem pedicle. When the tumor is compressed by the lens body, the shape can be changed and the living body can be taken. The tissue examination is mostly normal mucosa. When the cyst is clamped, the mass can disappear.
Diagnosis
Diagnosis and diagnosis of intestinal air sac
diagnosis
Can be diagnosed based on clinical performance and laboratory tests.
Differential diagnosis
I. Intestinal cyst
The disease often occurs at the distal end of the ileum and is located in the intestinal wall. It is more common in children and is usually a single tumor.
2. Colon polyps and malignant tumors
Identification mainly relies on X-ray barium meal and endoscopy. When X-ray barium is examined, the filling defect caused by polyps or tumors does not change in size and shape due to the amount of barium filling, and its density is higher than that caused by balloon swelling. The defect is high and colonoscopy and biopsy can confirm the diagnosis.
3. Intestinal lymphangioma
Surgical exploration looks similar, but the capsule contains liquid.
