tuberculous mesenteric lymphadenitis
Introduction
Introduction to tuberculous mesenteric lymphadenitis Primary tuberculous mesenteric lymphadenitis occurs when the Mycobacterium tuberculosis spreads through the bloodstream or enters the corresponding lymph nodes, or the original lesion of the intestinal wall has completely healed without leaving traces. Secondary is also secondary to tuberculosis or intestinal tuberculosis, usually involving varying numbers of lymph nodes, varying in size; pale yellow, grayish white or pink, and easy to fuse together in a mass, with intestinal, peritoneal, large Omental adhesions, almost all of the cheese-like changes; sometimes necrotic liquefaction can be broken into the abdominal cavity, intestinal lumen, or discharged through the abdominal wall. Scattered or extensive calcification can be seen after the disease is cured. basic knowledge Sickness ratio: 0.05% Susceptible people: children are more common Mode of infection: non-infectious Complications: ascites edema pyloric obstruction intestinal obstruction
Cause
Causes of tuberculous mesenteric lymphadenitis
Primary tuberculous mesenteric lymphadenitis is caused by dissemination of Mycobacterium tuberculosis by blood circulation or intestinal mucosa into the corresponding lymph nodes, secondary tuberculous mesenteric lymphadenitis secondary to tuberculosis or intestinal tuberculosis.
Prevention
Tuberculous mesenteric lymphadenitis prevention
Active prevention and treatment of tuberculosis and intestinal tuberculosis is the key to the prevention of this disease, and attention should be paid to dietary nutrition.
Complication
Tuberculous mesenteric lymphadenitis complications Complications ascites edema pyloric obstruction intestinal obstruction
The enlarged lymph nodes can compress the portal vein to block the reflux, produce ascites and abdominal varices; compress the inferior vena cava to cause lower extremity edema; oppress the pylorus to cause pyloric obstruction; oppress the intestine to cause incomplete intestinal obstruction.
Symptom
Tuberculous mesenteric lymphadenitis symptoms Common symptoms Abdominal pain constipation Diarrhea weight loss Low heat loss Appetite loss Lymph node tuberculosis Calcified edema
The disease is more common in children, acute mesenteric lymph node tuberculosis, patients with persistent low fever, fatigue and discomfort, umbilical or right lower abdomen often have persistent dull pain, sometimes paroxysmal aggravation, can also be manifested as acute abdominal pain, similar to colic, With nausea, vomiting, may have diarrhea or constipation, umbilical or left upper abdomen during physical examination, right lower abdomen can be swollen and swollen lymph nodes, tenderness, often suspected of acute appendicitis and surgery.
Chronic mesenteric lymph node tuberculosis, chronic poisoning symptoms and malnutrition, manifested as long-term irregular hypothermia, loss of appetite, weight loss, anemia, fatigue, diarrhea, sometimes agglomerated and swollen lymph nodes, relatively fixed, not easy Push, swollen lymph nodes can press the portal vein to block the reflux, produce ascites and abdominal wall varicose veins; oppression of the inferior vena cava caused by lower extremity edema; oppression of pyloric pyloric obstruction; compression of intestinal tract caused by incomplete intestinal obstruction, in adults, lack of clinical Symptoms, but manifested as umbilical hernia and abdominal mass, found in the laparotomy as lymph node tuberculosis.
Preoperative abdominal X-ray film showed calcification, gastrointestinal barium examination showed signs of irritation in the intestine, signs of intestinal tube compression or adhesion caused by the tumor, positive OT test, all helpful diagnosis, electronic computed tomography scan can be found in the abdomen Lymph nodes with different sizes or fused into a cluster may have a necrotic liquefaction zone in the center.
Examine
Tuberculous mesenteric lymphadenitis
1. Abdominal X-ray film found calcification.
2. Gastrointestinal barium meal examination shows signs of irritation in the intestine, signs of intestinal tube compression or adhesion caused by the mass.
3. The OT test is positive.
4. The electronic computed tomography scan can detect lymph nodes of different sizes or fused into abdomen in the abdomen, and there may be a necrotic liquefaction zone in the center.
Diagnosis
Diagnosis and diagnosis of tuberculous mesenteric lymphadenitis
diagnosis
Can be diagnosed based on clinical symptoms and laboratory tests.
Differential diagnosis
To consider chronic or acute appendicitis, even patients with gastric and duodenal ulcers, cholecystitis, abdominal lymph nodes should be differentiated from limited ileitis, lymphogranuloma, lymphosarcoma and other abdominal tumors.
