connective tissue enteritis
Introduction
Introduction to connective tissue enteritis Connective tissue diseases involve scleroderma of the gastrointestinal tract, systemic lupus erythematosus, nodular polyarteritis, dermatomyositis, rheumatoid arthritis, etc. Among them, scleroderma is the most prominent. basic knowledge The proportion of illness: 0.0005% Susceptible people: no specific population Mode of infection: digestive tract spread Complications: ulcerative colitis acute appendicitis
Cause
Cause of connective tissue enteritis
1. 57% of patients with scleroderma have intestinal involvement, pathological changes in the small intestine have smooth muscle atrophy, submucosal, muscular and serosal patchy collagen fibers deposit, and the mucosal membrane has chronic inflammatory cell infiltration.
2. In the dermatomyositis, the small intestine has different degrees of dilatation and segmentation changes, accompanied by low motility and prolonged passage time. The intestinal wall edema and thickening are visible to the naked eye. Microscopic examination reveals multiple mucosal erosions, submucosal edema, and muscular atrophy. Fibrosis with lymphatic and plasma cell infiltration, intestinal mucosa to serosal small artery, venule intimal thickening is prone to thrombosis and luminal occlusion.
3. Intestinal damage of systemic lupus erythematosus is mainly the result of vasculitis, manifested as fibrin-like degeneration, thrombosis, hemorrhage and ischemia, mainly invading the lower intestinal mucosa, muscularis and mesenteric arterioles, venules.
4. Nodular polyarteritis may involve any part of the intestine, but mainly invades the mesenteric, small arteries and submucosa and myometrial arterioles, followed by venules, and the lesions are segmental, with all layers of the wall Involved, histology is characterized by fibrin-like degeneration, necrosis and thrombosis, accompanied by inflammatory cell infiltration.
5. Rheumatoid arthritis can also be complicated by intestinal malabsorption, steatorrhea and selective lactose intolerance, malabsorption is caused by concurrent small intestinal amyloidosis, and can also be associated with loss of gastrointestinal protein.
Prevention
Connective tissue enteritis prevention
First, pay attention to household hygiene, install screens, put out flies, cockroaches, and clean the environment.
Second, avoid bringing children to public places.
Third, avoid eating cold and unclean things.
Fourth, the children's food utensils pay attention to safety and cleanliness.
5. Isolate the patient and handle its excretion carefully.
6. Personal hygiene and hygiene education, especially those with children, should wash their hands frequently, wash their hands after changing diapers for children; wash hands after contact with children's secretions to avoid bacterial transmission to children.
Complication
Connective tissue enteritis complications Complications ulcerative colitis acute appendicitis
A small number of patients have atrophy of the villi, accompanied by intestinal absorption of protein-free enteropathy, localized enteritis, non-specific ulcerative colitis, acute appendicitis, etc., severe cases can cause intestinal ulcers, infarction, perforation.
Symptom
Connective tissue symptoms of intestinal inflammation Common symptoms Loss of appetite Abdominal pain Diarrhea Bloating constipation Gastrointestinal symptoms Edema Nodules Intestinal wall edema Thickening nausea
1. Patients with scleroderma may have abdominal discomfort, abdominal distension, postprandial ventral dysfunction, loss of appetite, nausea, vomiting, and intermittent diarrhea and constipation.
2. In the dermatomyositis, the small intestine has different degrees of dilatation and segmentation changes, accompanied by low motility and prolonged passage time, and the intestinal wall edema and thickening are visible to the naked eye.
3. Intestinal damage of systemic lupus erythematosus is mainly the result of vasculitis. Common gastrointestinal symptoms include abdominal pain, loss of appetite, nausea, vomiting, rare diarrhea, black feces, occasional intestinal obstruction, and a few patients have atrophy of the villi. The small intestine absorbs no protein-losing enteropathy, localized enteritis, non-specific ulcerative colitis, acute appendicitis, and the like.
4. Nodular polyarteritis Intestinal symptoms are common. Intestinal ischemia, abdominal pain, vomiting or diarrhea, vascular occlusion can cause intestinal ulcers, infarction, perforation, and sometimes clinical symptoms resemble localized enteritis or non-special Ulcerative colitis.
Examine
Examination of connective tissue enteritis
1. X-ray examination of the duodenum and duodenum and proximal jejunal dilatation are characteristic, sometimes the entire small intestine is dilated, the annular fold is often thickened, and the edge of the intestine is burr-like.
2. Dermatomyositis microscopic examination showed multiple mucosal erosion, submucosal edema, muscular atrophy and fibrosis with lymphatic and plasma cell infiltration, intestinal mucosa to serosal small artery, venule intimal thickening and easy thrombosis And the lumen is occluded.
3. X-ray examination of nodular polyarteritis shows small intestinal mucosal disorders, ulcers, polypoid hyperplasia, segmental stenosis, etc., also resembles the X-ray manifestations of localized enteritis or non-specific ulcerative colitis.
Diagnosis
Diagnosis and diagnosis of connective tissue enteritis
diagnosis
Can be diagnosed based on clinical performance and laboratory tests.
Differential diagnosis
Mainly differentiated from bacterial dysentery, viral enteritis, cholera, intestinal amoeba.
