intestinal stone obstruction
Introduction
Introduction to enteric stone intestinal obstruction The enteric stone is a bile acid stone formed by the insoluble water and the dip salt of the digestive juice, the calcium salt and the like, the swallowing substance or the substance normally present in the intestine, and the obstruction caused by the stenosis of the intestinal cavity by the stone is called the intestine. Stone intestinal obstruction. basic knowledge The proportion of sickness: 0.0031% Susceptible people: no specific people Mode of infection: non-infectious Complications: volvulus
Cause
Causes of enteropathic intestinal obstruction
Primary factor (55%):
Primary intestinal intracholinthiasis may be due to excessive gastric acid secretion, lowering the pH of the proximal jejunum, or overgrowth of the bacteria in the intestinal fistula, causing the pH of the jejunum to decrease, and at the same time decomposing the bile salts to form bile acids. The lower pH jejunum is insoluble in water to form bile acid crystals, which can be used as the core of the stone.
Secondary factors (45%):
With certain inorganic salts that cannot be dissolved or digested, food or foreign matter forms special coagulum or lumps in the gastrointestinal tract, which becomes intestinal stones. The stones enlarge and block the small intestine, which leads to intestinal intestinal obstruction.
Pathogenesis
According to the mixed components of intestinal stones, the intestinal stones that cause obstruction can be divided into three types:
1 true gut stone: generally consists of a gut epithelium, small feces, cores and other foreign matter, forming a core, formed by the deposition of inorganic salts,
2 drug-induced enteric stone: it is because of the insoluble lumps formed in the intestine after long-term oral administration of drugs containing calcium, phosphorus, magnesium, etc.
3 mixed enteric stone (plant hairy stone): formed by the ingestion of certain fruits, vegetables or swallowed hair, especially the immature fruit.
Among the stones causing intestinal obstruction, plant hairy stone is more common, among which the plant dung stone formed by persimmon is the most common. The immature persimmon pulp and mature persimmon skin contain tannic acid, and tannic acid forms contact with stomach acid. Glue-like polymer precipitates, and continuously adsorbs plant fibers into agglomerates, and then forms inorganic stones by depositing inorganic salts containing calcium, phosphorus, magnesium, etc. The more the amount of persimmons is, the easier it is to form, and the more Seen in a mental disorder, swallowed themselves or others, animal hair, leaf fiber, wool coat, etc., more hair can be entangled with the gastrointestinal motility and become a serving, thus forming a strong isolated mass, also reported gastrointestinal Part of the anastomosis line is detached and forms a stone-induced intestinal obstruction. Patients with a history of gastric surgery, such as subtotal Abdominal Abdominal Billroth II anastomosis, vagus nerve cutting, pyloric angioplasty, etc., are more likely to form stones. Michael reported 113 cases of gastrointestinal stones. Among them, 106 cases have undergone stomach surgery. The reason is that after gastric surgery, the gastric peristalsis is slow and the emptying is delayed, so that the stomach contents are in contact with gastric acid for a long time, and it is easy to form stomach stones, especially After persimmon, gastric surgery, especially Billroth anastomosis, anastomosis because large gastrolith formation in the stomach and into the small bowel obstruction caused more easily in the gut and intestinal diverticula at the narrow proximal intestine stone can be easily formed.
Prevention
Enteric stone intestinal obstruction prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Enteropathic intestinal obstruction complications Complications
Intestinal torsion, intestinal wall necrosis and perforation are common complications of this disease.
Symptom
Intestinal stone intestinal obstruction symptoms Common symptoms Acute intestinal torsion peritonitis Upper gastrointestinal bleeding intestinal wall necrosis Femur seen in the red...
The clinical manifestations of enteropathic intestinal obstruction are similar to those of gallstone intestinal obstruction. It usually begins with partial obstruction. When the intestinal stone moves to the end of the smaller ileum with intestinal peristalsis, complete intestinal obstruction can occur, so obstruction The site is also more common at the end of the ileum. A few cases can be found in the duodenum, colon, rectum, etc. When the intestinal stone is rubbed or compressed, the intestinal mucosa may be necrotic, and gastrointestinal bleeding may occur, which may also cause intestinal torsion, intestinal wall necrosis, and perforation. In the case of diffuse peritonitis, brownish red skin or hair can sometimes be seen in vomit or feces.
Examine
Examination of intestinal stone intestinal obstruction
1. X-ray abdominal plain film showed signs of partial or complete intestinal obstruction, and barium meal or barium enema showed intestinal dilatation and intestinal filling defect.
2. Gastroduodenoscopy has a great help for gastrolithic and duodenal obstruction.
3. B-ultrasound can be seen in the intestine cavity with strong eclipse reflux and arc-shaped inhomogeneous strong echo zone, behind the echo zone there is a sub-attenuated sound shadow.
Diagnosis
Diagnosis and identification of intestinal stone intestinal obstruction
According to the medical history, combined with X-ray, endoscopy and B-ultrasound examination, the diagnosis is generally not difficult, but the atypical performance can only be diagnosed by surgery.
