Diffuse jejunal ulcer
Introduction
Introduction to diffuse ileal ulcer Diffuse jejunal ulcers are rare, also known as chronic granulomatous vaginitis, chronic idiopathic ulcerative enteritis. Occurs in people over the age of 50, more men than women, about 3:1, diarrhea, abdominal pain, malabsorption and protein-losing enteropathy are common manifestations. Common complications include intestinal perforation and gastrointestinal bleeding, and less complicated intestinal obstruction. The ulcers of this disease are multiple, most often involving the jejunum, followed by the ileum, occasionally in the duodenum, stomach or colon. basic knowledge The proportion of sickness: 0.003%-0.005% Susceptible people: good for the elderly Mode of infection: non-infectious Complications: abdominal pain, intestinal obstruction
Cause
Causes of diffuse empty ileal ulcer
(1) Causes of the disease
The cause is unknown, common in patients with celiac disease, and some patients also have lymphoma and intestinal adenoma, but whether these diseases are the cause of this disease, further clarification.
(two) pathogenesis
The ulcers of this disease are multiple, most commonly involving the jejunum, followed by the ileum, occasionally in the duodenum or colon, the ulcer is generally deep, reaching the muscular layer, so it is easy to cause perforation or serosal scar contracture, microscope It can be seen that the small intestine villi atrophy, lymphocytes, plasma cells, tissue cells and neutrophils infiltrate at the bottom and around the ulcer. The gastric mucosa metaplasia is sometimes seen on the edge of the ulcer, and the intestinal mucosa between the ulcer and the ulcer is normal or inflammatory.
Prevention
Diffuse empty ileal ulcer prevention
Rest has great benefits for the rehabilitation of patients. Especially for active patients, it is necessary to emphasize full rest, because the quiet and comfortable resting environment can reduce the mental and physical burden of the patients, especially to relax before going to bed, to ensure the sleep effect, if necessary Take a sedative. The patient can gradually increase the amount of activity after the condition improves, but generally should reduce the heavy physical activity.
Complication
Diffuse jejunal ulcer complications Complications abdominal pain intestinal obstruction
Ulcer perforation can occur, perforation often occurs intermittent abdominal cramps, followed by severe abdominal pain, intestinal obstruction is also a common complication, occasional intestinal bleeding.
Symptom
Diffuse jejunal ulcer symptoms Common symptoms Diarrhea Abdominal pain Intestinal perforation Small bowel injury
Occasionally occurs in the elderly, diarrhea, abdominal pain, malabsorption and protein-losing enteropathy are common manifestations, common complications are intestinal perforation and gastrointestinal bleeding, less complicated with intestinal obstruction.
Examine
Diffuse empty ileal ulcer examination
X-ray angiography or endoscopy revealed small bowel ulcers, and oral jejunal mucosal biopsy sometimes yielded diagnostically valuable specimens.
Diagnosis
Diagnosis and diagnosis of diffuse ileal ulcer
diagnosis
Diagnosis is more difficult, X-ray angiography or endoscopy to find small intestine ulcers, if other diseases can be ruled out, this disease should be considered, specimens of diagnostic value can sometimes be obtained by oral jejunal mucosal biopsy, but care should be taken to avoid intestinal perforation. Surgical exploration, postoperative intestinal resection specimen biopsy is a reliable basis for diagnosis.
Differential diagnosis
Bacterial dysentery
Caused by Shigella, diarrhea with pus or mucus is more common, less, and often urgency and heavy, more cold and heat, stool microscopic examination can find a large number of pus cells, red blood cells and phagocytic cells, infant poisoning bacteria Or atypical bacillary dysentery should be identified by pathogenic diagnosis.
2. Viral diarrhea
Diarrhea caused by enterovirus infection, characterized by highly contagious, rotavirus, small round virus and other infections have vomiting in the early stage, successive diarrhea, more watery stools and mucus, mostly in autumn and winter, other viral Diarrhea is more common in summer and autumn, nausea and vomiting, in addition to gastrointestinal symptoms, often have respiratory symptoms, pharyngitis, and convulsions, often involving the neck muscles, back muscles, children in the age of more common green watery or egg-like water Antibiotic treatment is generally ineffective, and the course of disease is self-healing in 5 to 7 days. It is further identified by serology and virus isolation.
3. Campylobacter enteritis
Campylobacter jejuni causes mild and viral enteritis, and is similar to ulcerative colitis or Crohn's disease. It has fever, diarrhea or mucus-like stool, stench, bile color, severe pus and bloody stools. More than one week of recovery, children often have abdominal cramps, convulsions can occur when high fever, the incidence is more related to contact with poultry, livestock or drinking unsterilized milk, raw water, dark field microscopic examination can find the bending of the archery-like active power Bacteria, bacterial culture for further diagnosis.
