gastric syphilis
Introduction
Introduction to stomach syphilis Syphilisofstomach is a rare stomach disease caused by the invasion of the stomach wall by Treponema pallidum. Mainly because of the syphilis that adults are mainly infected through sexual behavior. Clinically divided into three phases, in addition to invading the skin and mucous membranes, it can also involve internal organs, which is a relatively serious sexually transmitted disease. It is mainly transmitted through sexual behavior, and can also be indirectly transmitted by blood transfusion, surgery or even clothing. basic knowledge Proportion of the disease: the incidence rate of multi-sex partners is about 2% - 5% Susceptible people: no special people Mode of transmission: sexual transmission, blood transmission Complications: gastric ulcer, gastroduodenal ulcer, scar pyloric obstruction
Cause
Cause of gastric syphilis
Cause:
Gastric syphilis is caused by the invasion of syphilis spirochetes.
Pathogenesis
The lesion begins in the lower layer of the gastric mucosa. Early syphilis can affect the stomach wall, but most of them are transient. The pathological changes of the second stage syphilis gastric mucosa are not specific. The gastric lesion is mainly caused by the third stage syphilis, which is characterized by inflammatory infiltration and Forming a gum-like swelling, single or multiple, histological changes in granuloma, visible central epithelial cells, fibroblasts and giant cells surrounding central necrotic lesions, pathogens in the dark field of silver staining or fluorescein-labeled antibody staining It can also be found by immunization. The inflammatory infiltration is mainly in the submucosal layer, and the muscle layer can also be thickened. The surface of the lesion is smooth and the color is dark. It can also form a typical gum in the stomach wall. After the knot, it will break into an ulcer, and it will have a hard knot when it comes into contact, forming a scar or breaking through the stomach wall.
Prevention
Stomach syphilis prevention
1. Within 3 months, any sexual partner who has been exposed to infectious syphilis should be examined, diagnosed and treated.
2. Early syphilis prohibits sex during the treatment period.
3. The most important thing about preventive contact infection is self-love, sexual partners should be specific, avoid unclean sex, and multiple sexual partners.
4. To prevent blood transmission, do not use drugs, do not share syringes and needles with others; try not to transfuse blood or inject blood products, do not share toothbrush towels with others.
5. It should be noted that if you find yourself with suspicious symptoms such as ulcers and rashes, especially after having dangerous sexual behaviors, you should go to a regular hospital for medical treatment in time to achieve early detection, early treatment, and early cure. Patients with syphilis can be asymptomatic, so even if they are asymptomatic, they may have been infected with syphilis.
Complication
Gastric syphilis complications Complications gastric ulcer gastroduodenal ulcer scar pyloric obstruction
Gastric lesions are mainly caused by advanced syphilis, which can form typical gums in the stomach wall, but it is rare. After the gums are broken, ulcers can form, scars or penetrate the stomach wall. The stomach is deformed into sand clocks due to the formation of scars. shape.
Symptom
Symptoms of stomach syphilis Common symptoms Upper abdominal pain Peptic ulcer Abdominal pain Abdominal distension Nausea weight loss
Symptoms develop slowly, but progressively worsen, as the volume of the stomach shrinks and the ulcers become obvious. It begins to manifest as pain or discomfort in the upper abdomen after meals, accompanied by upper abdominal distension, nausea, vomiting and weight loss, fatigue, etc. due to stomach scars. Formation and pyloric obstruction, abdominal pain and vomiting worse, some patients with symptoms similar to peptic ulcer, a few cases of abdominal examination can touch the mass.
Examine
Stomach syphilis examination
The blood Kangwa reaction was mostly positive. There was no significant change in gastric acidity in early gastric syphilis, and gastric acid secretion decreased in the late stage.
1. X-ray barium meal imaging can prompt:
(1) Sand bell stomach.
(2) The diffuse stomach wall is involved and forms a leather stomach.
(3) Gastric filling defect.
(4) The gastric volume is reduced and the tube is narrow.
(5) mostly shallow ulcers, X-ray examination is not easy to find, such as large ulcers, X-ray examination of cancerous ulcers.
2. Gastrointestinal changes in gastric syphilis showed gastric hyperplasia, including gastric mucosal congestion, erosion, scattered bleeding points, superficial ulcers in the antrum of the stomach, gastric sinus stenosis in the late syphilis, weakened gastric wall peristalsis, and formation of gums Large irregular ulcers, the appearance is difficult to distinguish from cancerous ulcers.
Diagnosis
Diagnosis and differentiation of gastric syphilis
Gastric syphilis has no specific symptoms, and it is difficult to diagnose. According to the history of previous diseases, the history of sputum sputum and gastric X-ray examination, serum antigen reaction, help to confirm the diagnosis, gastroscopy and biopsy meet the pathological changes of syphilis, can confirm the diagnosis After anti-syphilis treatment, X-ray barium meal imaging of the stomach shows that the lesion is improved or disappeared, which is helpful for diagnosis.
Gastric syphilis is sometimes difficult to distinguish from gastric cancer and gastric ulcer, but gastric syphilis occurs in young patients who have not been treated with anti-syphilis. The course of disease is longer, the weight loss is slower than that of gastric cancer, and sometimes it is necessary to undergo biopsy or pathological examination after surgery to confirm the diagnosis. .
