Colon fistula
Introduction
Introduction to colon fistula Colonic hernia is a common surgical pathological condition. The abnormal passage between the gastrointestinal tract due to various reasons, the pathological path between the intestine and other hollow organs or between the intestine and the body surface belongs to the intestinal fistula. The category, if it occurs in the colon, is called colonic fistula. The colonic fistula can be divided into two types: external hemorrhoids and internal hemorrhoids. The contents of the intestines are called external hemorrhoids, and the fistulas are connected with another intestine or other hollow organs. Called guilty. basic knowledge The proportion of illness: the incidence rate is about 0.0001%-0.0005%, very rare Susceptible people: no specific population Mode of infection: non-infectious Complications: peritonitis malnutrition
Cause
Cause of colonic fistula
Tubular :
It can be formed after pathological or postoperative operation, especially the abdominal drainage tube is hard, and the colon wall necrosis caused by compression of the colon is small. The tube is small and the tube is long, and most of the intestinal contents flow into the intestine of the distal end of the fistula. Part of it flows out of the mouth.
Lips:
Mostly caused by trauma, the intestine is close to the abdominal wall, and a part of the intestinal mucosa is turned out of the fistula. The contents of the intestine are partially discharged from the external fistula and partially into the distal intestine.
Completely :
Mostly due to surgery, the intestine is fully valgus, exposing the abdominal wall, and most or most of the contents of the intestine flow out of the mouth.
Prevention
Colonic fistula prevention
In the various surgical operations of the intestines, attention should be paid to the treatment of wounds to prevent the formation of gargles, and at the same time, attention should be paid to daily life:
1. Establish normal dietary habits.
2. Prevention of constipation and diarrhea.
3. Develop good bowel habits.
Complication
Colonic fistula complications Complications, peritonitis, malnutrition
Often accompanied by abdominal infection caused by severe peritonitis, intestinal contents caused by loss of water and electrolytes caused by loss of mouthwash and malnutrition and other diseases.
Symptom
Symptoms of colonic fistula Common symptoms Digestive tract perforation Abdominal infection Abdominal pain Abdominal muscle tension Abdominal wound outflow Fecal sample Abdominal tenderness Toxemia
Colonic injury, inflammation or tumor, etc. After colonic or intestinal resection and anastomosis, anastomotic rupture and leakage occurred. It occurred 4 to 5 days after surgery. After the operation, abdominal pain was relieved, and persistent abdominal pain increased. With toxemia, such as elevated body temperature, abdominal tenderness, rebound tenderness and abdominal muscle tension are also getting worse, then you should first test the abdominal cavity infection, or the possibility of intestinal fistula, abdominal incision sputum drainage in the intestinal secretions It is reliable evidence of intestinal fistula, but it is difficult to accurately determine the location of the internal sputum. Generally speaking, the ileal effluent is mostly yellow rice porridge or thin paste, and the colonic sputum discharge is semi-formed or non-formed.
Examine
Examination of colonic fistula
1. Oral activated carbon powder or injection of methylene blue solution from the stomach tube, the wound out of carbon powder or blue liquid, confirmed the presence of intestinal fistula, according to the time required after oral or injecting the drug to the mouth, it can also help determine the inside The part of the mouth.
2, X-ray examination: review the abdominal cavity flat film, showing the increase of free gas under the armpit, can also prove the possibility of intestinal fistula (the underarms can be stored in the residue after surgery, but should be gradually reduced).
3, fistula angiography: If there is a fistula, can be injected through the fistula catheter to inject contrast agent, can help to understand the presence and location of the intestinal fistula, size, the direction of the fistula and the surrounding intestinal tube.
4, gastrointestinal sputum examination: help to understand the location of sputum, the size of sputum and the distal end of the sputum obstruction.
5, B-mode ultrasound examination: mainly to understand whether there are residual infections in the abdominal cavity and its location and size.
Diagnosis
Diagnosis and identification of colonic fistula
Excretion of fecal samples from abdominal wounds is a definitive evidence for the diagnosis of intestinal fistula, and examinations have confirmed that abnormal passages in the colon and abdominal wall can also be diagnosed. It is mainly necessary to identify with other mouthwashes of the intestines.
