gastrolithiasis
Introduction
Introduction to stomach stone disease A foreign body formed by ingesting certain botanical ingredients or swallowing hair or certain minerals such as calcium carbonate, sputum, tincture, etc., which is formed by coagulation in the stomach, is called gastric bezoar. Under the action of gastric acid, tannin and protein are combined into a tannic acid protein, which is bonded with pectin, gum and cellulose to form stomach persimmon. A high acid environment is a condition in which stomach stones occur. Hawthorn, black dates and so on also contain a lot of pectin and enamel, often forming stomach stones. basic knowledge Sickness ratio: 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: superficial gastritis, gastric ulcer, gastric bleeding, pyloric obstruction, abdominal pain, intestinal obstruction
Cause
Cause of gastrolithiasis
Habit factor (30%):
Hairballs composed of hair are more common, accounting for about 55% of the cases of hairy feces reported in the literature. 90% of the disease is female, especially neurotic girls often have the habit of biting and swallowing hair, which is most likely to occur. In this disease, the hairball is mainly composed of a large number of hairs of different lengths. It may be mixed with wool, wool and plant fibers. It contains dark, green or black color due to the spoilage decomposition of various foods. And often have abnormal stench.
Dietary factors (30%):
It is made up of skin, seeds, leaves, roots and fibers of various plants, accounting for about 40% of the earthy stone. The most common ones are formed after eating persimmons, but also because of eating coconut, celery and pumpkin. The fiber is formed, the most easy to form plant balls after eating raw persimmons, because the raw persimmon contains a large amount of persimmonic acid, and it becomes a very viscous gel with the action of stomach acid, and the fiber of the plant can be Skin, seeds, etc. are combined to form a plant ball.
Individual factors (30%):
It is the rarest one, accounting for only 3% to 5% of the shale stone. The most peculiar one is the painter's habit of sucking paint water (a kind of shellac alcohol), which can be rosin or The gradual deposition of the resin forms huge stones. Some drugs such as sputum taken during gastrointestinal angiography, magnesium carbonate or tincture taken by patients with ulcer disease may also form stones in the stomach.
Prevention
Gastrolithic prevention
Avoid eating a large number of persimmons, black dates, etc. on an empty stomach, overcoming the quirks of chewing hair, and actively treating gastrointestinal motility disorders to prevent the re-formation of stomach stones. It is best not to eat hawthorn on an empty stomach, but also to avoid eating milk, sweet potatoes, coffee, seafood, and other foods that are rich in protein and stimulate gastric acid secretion.
Complication
Gastrolithic complications Complications superficial gastritis gastric ulcer gastric bleeding pyloric obstruction abdominal pain intestinal obstruction
Common clinical complications are superficial gastritis and gastric ulcer, the incidence rate is 60% to 70%. Patients with gastritis, gastric ulcer, gastric bleeding or pyloric obstruction may have repeated abdominal pain or hematemesis, vomiting, etc. Corresponding clinical manifestations, occasionally major bleeding, perforation or gastrolithic into the intestine causing intestinal obstruction, its clinical signs and symptoms are more obvious and serious.
Symptom
Symptoms of gastrolithic symptoms Common symptoms Gastrointestinal formation of abdominal pain, abdominal distension, upper abdominal discomfort, upper abdominal pain, black stool, peritonitis, loss of appetite, nausea
Gastric stone is easy to occur in the vagus nerve resection of the major gastrectomy. Patients with gastroparesis syndrome may be related to gastric dysfunction in this part of the patient. They can be divided into acute and chronic types. The course of the disease is acute within 6 months. More than 6 months is chronic, more common in acute cases, acute type in a large number of persimmons, hawthorn and other symptoms 1 to 2 hours, more than half of patients have upper abdominal pain fullness, nausea, vomiting, generally not much vomiting, may have Vomiting brown or bloody substances, and a large number of hematemesis is rare, physical examination, 30% of cases touch the upper abdomen sliding mass, due to the stimulation and damage caused by the local stone mucosa, often accompanied by gastric ulcer, gastric mucosal erosion, pyloric obstruction, intestine Obstruction, occasional perforation and peritonitis.
Examine
Gastrolithic examination
Some patients may be small cell hypochromic anemia, some patients with positive fecal occult blood test, persimmon skin samples can be seen at the beginning, gastric juice analysis showed that gastric free acid increased compared with normal people.
X-ray inspection
X-ray barium meal or air sputum double contrast, can be found in the stomach to produce shunt phenomenon, and showed floating in the upper layer of the tincture free, agglomerate, round or oval filling defect area, and gastric mucosal structure The stomach wall is soft. When the sputum in the stomach is empty, there is still a strip-like shape on the lumps, and the reticular or flaky plaque adheres. The shadow of the pressing block has no obvious tenderness, and the contour shape and position can be changed with the force. , suggesting that the agglomeration has a certain degree of compression and migration.
2. Fiber endoscopy
Under fiberoptic endoscopy, the morphology and traits of the stones in the stomach can be directly observed. The vegetative gas stones can be yellow, brown, brown or green, often round, oval or single or multiple free. Agglomerate, the gray stone is generally black or tan, in a "J" shape or kidney shape, can be filled with the stomach or into the duodenum, fiber endoscopy can also understand whether the stomach has gastritis, ulcer disease, etc. Other signs, if necessary, can also be used to analyze the gastric tissue of agglomerated components or complications. Therefore, patients with conditional hospital gastroenterology should consider fiber endoscopy as the preferred diagnostic tool.
3.B-ultrasound
B-ultrasound is helpful for the diagnosis of gastrolith. Usually, the patient drink 500-1000ml of water, sitting or semi-recumbent examination. It can be seen that there is a clear echo image of the echo in the stomach, floating on the water layer, and can change with body position or The stomach creeps and changes position.
Diagnosis
Diagnosis of gastrolithic disease
Chronic gastric persimmon patients, due to long course of disease, symptoms are often similar to chronic gastritis, ulcer disease or gastric cancer, but it is easy to distinguish with the above diseases by X-ray barium angiography or gastroscopy.
Chronic gastritis: manifested as upper abdominal pain or discomfort, upper abdominal distension, early satiety, belching, nausea and other symptoms of dyspepsia. The presence or absence of these symptoms and their severity was not positively correlated with endoscopic findings and histopathological changes in chronic gastritis. Patients with autoimmune gastritis may also be associated with anemia.
Gastric ulcer disease: symptoms of gastric ulcer often atypical can be manifested as upper abdominal pain and upper abdominal discomfort. Most people have various symptoms of dyspepsia, but some have no symptoms until complications occur. Common complications include hemorrhage, perforation, pyloric obstruction, and cancer. Common gastrointestinal symptoms and systemic symptoms mainly include hernia, acid reflux, upper abdominal distension, burning sensation after sternum, nausea, vomiting, and anorexia. The acid reflux and post-sternal burning sensation is due to the relaxation of the cardia. The nausea and vomiting reflect that the ulcer may indicate that the ulcer is in the active phase. Frequent vomiting and eating, suggesting pyloric obstruction. Some patients have symptoms of autonomic dysfunction such as insomnia and sweating.
