retroperitoneal lymphadenitis
Introduction
Introduction to retroperitoneal lymphadenitis Retroperitoneal Lymphnoditis is an acute, chronic or tuberculous retroperitoneal lymphadenitis caused by bacterial, viral or Mycobacterium tuberculosis infection. Retroperitoneal lymphadenitis is often difficult to diagnose before surgery. ESR is increasing, and tuberculosis, abdominal mass and low fever are common abnormalities in other areas. X-ray, B-ultrasound and CT, tuberculosis antibodies or tuberculin tests are all helpful in confirming the diagnosis. The final diagnosis depends on the biopsy of the lesion. basic knowledge The proportion of illness: 0.004% Susceptible people: no special people Mode of infection: non-infectious Complications: pyloric obstruction, portal hypertension, portal hypertension
Cause
Causes of retroperitoneal lymphadenitis
Bacterial infection (35%):
Bacterial infection is an acute systemic infection caused by pathogenic bacteria or conditional pathogens invading the blood circulation, producing toxins and other metabolites. It is characterized by chills, fever, rash, joint pain and hepatosplenomegaly. Some may have septic shock and migratory lesions. The disease is mostly caused by infection of the gastrointestinal tract or infection of other organs through systemic blood circulation.
Virus infection (25%):
An infectious disease caused by a virus that can breed in the human body and can cause disease. Mainly manifested as fever, headache, general malaise and other symptoms of systemic poisoning and local symptoms caused by inflammatory damage caused by viral hosts and invading tissues and organs. Mostly caused by upper respiratory tract infection or mumps.
Tuberculosis infection (25%):
Retroperitoneal lymphadenitis is more common in tuberculosis, which can be primary in the retroperitoneal lymph nodes, or secondary to tuberculosis in the gastrointestinal tract, abdominal cavity and lungs.
Prevention
Prevention of retroperitoneal lymphadenitis
Pay attention to rest in life, combine work and rest, eat properly, and prevent infection. Tuberculosis is the root cause of this disease. Therefore, once tuberculosis is found to be treated in a timely manner, early detection, early diagnosis, and early treatment are the key to prevention.
Complication
Retroperitoneal lymphadenitis complications Complications, pyloric obstruction, portal hypertension, portal hypertension
Gastrointestinal, abdominal and pulmonary tuberculosis, intestinal paralysis, pyloric obstruction, portal hypertension, biliary obstruction and fistula formation.
Symptom
Symptoms of retroperitoneal lymph nodes Symptoms Common symptoms of bowel biliary obstruction, nausea, abdominal muscle tension, low heat, relaxation, heat, abdominal tenderness, duodenal incision or stenosis
First, acute retroperitoneal lymphadenitis
Mostly with high fever and chills as the main symptoms, accompanied by abdominal pain, abdominal distension, low back pain, nausea, vomiting, etc., body temperature can reach 39 ~ 40 ° C, showing relaxation or heat retention, check abdominal tenderness rebound, but muscle tension is not Obviously, severe cases may have signs of intestinal paralysis, pain in the back and back, and white blood cells may increase.
Second, chronic or tuberculous retroperitoneal lymphadenitis
Tuberculosis can invade the posterior peritoneal lymph nodes. It can be used as one of the local components of the primary syndrome, or a result of widespread dissemination of tuberculosis. The affected lymph nodes can be treated in asymptomatic conditions, and finally calcified, and some lymph nodes are swollen. Experience dry necrosis, even the formation of abscess, the disease is more insidious, the symptoms are vague or even lacking, the main symptoms are persistent abdominal or paroxysmal pain or pain, accompanied by low fever, nausea, vomiting, bloating, loss of appetite, etc. The abdominal pain of this disease may be intermittent, and the anti-infective or anti-tuberculosis and antispasmodic treatments often have poor effects. It has been reported that the proximal ureter and kidney are compressed or displaced, pyloric obstruction, and the stomach wall is stiff. The duodenum has a notch or stenosis, duodenal intestinal fistula enlargement and transverse colon displacement, and rare manifestations include leg swelling, chyle-like ascites, portal hypertension, biliary obstruction and fistula formation, etc., and the abdomen may touch the mass or The limitations are full, deep tenderness, no abdominal muscle tension, and active bowel sounds.
Examine
Examination of retroperitoneal lymphadenitis
1. X-ray: Traditional X-ray examination of large vessels is the most commonly used and preferred method of imaging examination, which can clarify the diagnosis of many diseases.
2, B-type ultrasound: can obtain the cut surface image of the organ to be examined, can directly carry out an intuitive morphological observation, can clearly show the structure of the retroperitoneal lymph node.
3. CT: CT is different from X-ray imaging. It is a reconstructed image obtained by scanning the human body with X-ray beam, obtaining information, and processing by computer. What is shown is a cross-sectional anatomical image with a density resolution that is significantly better than an X-ray image. Thereby significantly expanding the scope of examination of the human body, improving the detection rate of the lesion and the accuracy of the diagnosis.
4. Tuberculosis antibody or tuberculin test.
Diagnosis
Diagnosis and differentiation of retroperitoneal lymphadenitis
diagnosis
The disease is often difficult to diagnose before surgery, ESR increases, tuberculosis is found in other sites (old or active), abdominal mass and low fever are common abnormalities, X-ray, B-mode ultrasound and CT, tuberculosis antibodies or tuberculosis The prime test, etc., all contribute to the diagnosis, and the final diagnosis depends on the biopsy of the lesion.
Differential diagnosis
It should be differentiated from lymphoma, pancreatic cancer, posterior peritoneal or mesenteric tumor, sarcoidosis, appendicitis, appendicitis, malignant tumor, benign lymphoid hyperplasia and infectious mononucleosis.
