Chronic ulcerative nongranulomatous jejuno-ileitis
Introduction
Introduction to chronic ulcerative non-granulomatous jejunal ileitis Individual patients with inflammatory diarrhea have improved symptoms after giving gluten-free food, but when they develop chronic ulcerative non-granulomatous jejunal ileitis, the gluten-free food can no longer relieve the symptoms. The main symptoms are abdominal pain, diarrhea, watery stool, and chronic persistent stubborn diarrhea. Systemic symptoms include fever, weight loss, and marked weight loss. The medical examination showed a state of cachexia, abdominal fullness, bowel movements, intestinal shape, and tender tenderness in the abdomen. basic knowledge The proportion of illness: 0.0003% Susceptible people: no special people Mode of infection: non-infectious Complications: abscess
Cause
Causes of chronic ulcerative non-granulomatous jejunal ileitis
(1) Causes of the disease
The cause is unknown. Individuals with inflammatory diarrhea have improved their symptoms after giving them gluten-free food. However, when they develop chronic ulcerative jejunitis, the gluten-free food can no longer relieve the symptoms. The relationship is still unclear.
(two) pathogenesis
In the surgical specimen or autopsy, there are multiple ulcers in the jejunum and ileum. There is a flat or normal mucosa between the ulcer and the ulcer. Lymphocytes, plasma cells and multinucleated cells can be seen in the ulcers under the microscope. Eosinophils can also be found in the intestines. The wall may have plaque thickening, no granuloma, inflammatory infiltrates and ulcers that extend to the full layer of the intestinal wall.
Prevention
Chronic ulcerative non-granulomatous jejunal ileitis prevention
Excessive sexual life is not good for the recovery of ulcerative non-granulomatous jejunal colitis, because fatigue is one of the important factors inducing the disease. It is best not to get pregnant in patients who are in advanced stage. Studies have shown that pregnancy can excite or aggravate the condition. There are infection, genetic, mental factors and allergies, but they can not fully explain the full picture of ulcerative colitis.
Complication
Chronic ulcerative non-granulomatous jejunal ileitis complications Complications
The disease is easy to produce blood, perforation, secondary infection, multiple abscesses, the course of the disease is generally serious and rapid development, can die of complications within 1 to 2 years.
Symptom
Chronic ulcerative non-granulomatous jejunal ileitis symptoms Common symptoms Diarrhea fever Fat diarrhea Abdominal pain Intestinal bowel intestine perforation Thinning intestinal hemorrhage edema
The main symptoms are diarrhea, watery stool, long course of disease, retrospective history often has diarrhea in childhood, the course can be several days to several months of remission, the remission period is healthy, asymptomatic, but eventually develops chronic persistence Stubborn diarrhea, some patients from the beginning is steatorrhea or later developed into steatorrhea, abdominal pain is also a common symptom, mostly colic, if hypoproteinemia occurs, often accompanied by limb edema, the disease is also prone to intestinal bleeding And intestinal obstruction, often become the cause of the first visit, systemic symptoms have fever, weight loss and significant weight loss, physical examination patients are cachexia, abdominal fullness, bowel hyperthyroidism, intestinal type, mild tenderness in the abdomen, such as ulceration Perforation, there are signs of acute peritonitis such as rebound pain.
Examine
Examination of chronic ulcerative non-granulomatous jejunum ileitis
Blood routine hemoglobin decreased, showing iron deficiency anemia; white blood cells can also be mildly elevated or decreased, normal classification; serum albumin and globulin are reduced; blood calcium is reduced, stool fat content is increased, more than 50g per 24 hours; stool It is bloody or only occult blood positive, small intestinal absorption function test such as xylose absorption test, vitamin B12 absorption test can be abnormal.
1. X-ray tincture examination: the small intestine presents a segmentation phenomenon; ulcers may not be found; intestinal stenosis and dilatation; segmental folds are irregular or thick.
2. Small colonoscopy: visible multiple ulcers in the jejunum ileum, the mucosa between the ulcers flattened or normal.
3. Mucosal biopsy: mucosal flattening, no difference with oral inflammatory diarrhea, little help for differential diagnosis.
Diagnosis
Diagnosis and diagnosis of chronic ulcerative non-granulomatous jejunal ileitis
diagnosis
Difficulties in diagnosis, mostly due to intestinal perforation or intestinal obstruction when surgery was discovered.
Differential diagnosis
1.Crohn's disease: The disease can occur in the entire digestive tract, but mainly involves the terminal ileum and adjacent colon. The lesions are segmentally distributed. The clinical features are abdominal pain, diarrhea, abdominal mass, intestinal fistula, and intestinal obstruction, often accompanied by Intestinal manifestations such as fever, the course of the disease is prolonged, and the episodes of remission occur alternately. The severe cases are prolonged and unhealed, often with various complications and poor prognosis.
2. Bacterial dysentery: all year round, the incidence is more common in summer and autumn, the main lesion is the suppurative inflammation of the colon, patients with less vomiting, often have fever, diarrhea with abdominal pain, urgency and weight, left lower abdomen tenderness, stool mixed with pus, mirror Red blood cells, pus cells and macrophages were observed and cultured with dysentery bacilli.
