intestinal adhesions
Introduction
Introduction to intestinal adhesion Intestinal adhesions are caused by various reasons between the intestines and intestines, between the intestines and the peritoneum, and between the intestines and the abdominal organs. There are two cases of membranous adhesion and cord-like adhesion in terms of adhesion characteristics, and there are two types of fibrin-like adhesion and fibrous adhesion from the nature of adhesion. In terms of etiology, the formation of adhesions is not only a congenital cause, but also a factor of injury or inflammation. Light can be without any discomfort. Or occasionally mild abdominal pain, bloating, etc. after eating. Severe cases can often be accompanied by abdominal pain, bloating, poor ventilation, suffocation, dry stools, air stagnation in the abdomen, and even lead to incomplete obstruction. Treatment is committed to adhesive intestinal obstruction. It is important to distinguish whether it is simple or strangulated, complete or incomplete. Because the surgery judges treatment does not specifically eliminate adhesions, on the contrary, new adhesions must be formed after surgery. Therefore, the special research on simple intestinal obstruction and incomplete obstruction is extensive adhesion, and non-application surgical guidance is generally used. basic knowledge The proportion of illness: 0.02%, more common in abdominal surgery Susceptible people: no specific people Mode of infection: non-infectious Complications: intestinal fistula secondary suppurative peritonitis
Cause
Intestinal adhesion cause
In terms of etiology, the formation of adhesions is not only a congenital cause, but also a factor of injury or inflammation.
Injury (35%):
(1) The intestinal tube exposure time is too long during the operation, air pollution, rough movement, large wound surface, severe damage to the serosa layer, incomplete hemostasis, postoperative oozing and percolation of the peritoneal cavity, uncleaning of the department or foreign bodies left in the abdominal cavity, etc. Can cause intestinal adhesions.
(2) Abdominal trauma, the abdomen is suddenly subjected to external impact, although the impact site has not broken and perforated, but there is also some damage, local tissue can occur congestion or edema or bloody exudation into the abdominal cavity, so that the surrounding tissue edema adhesion.
(3) Chemical drugs, such as the outflow of drugs from family planning and blockage, cause serious adhesions into the abdominal cavity.
Inflammation (35%):
(1) Inflammation in the abdominal cavity, causing inflammatory edema exudate or pus to overflow into the abdominal cavity, causing adhesions.
(2) Tuberculous peritonitis causes intestinal adhesions. Tuberculous peritonitis can be divided into dry and wet type dry type, which is characterized by the presence of fibrinous exudate in addition to tuberculous nodules on the peritoneum. After the machine, the abdominal cavity becomes the extensive adhesion of the mesenteric mesenteric viscera.
(3) intestinal tuberculosis causes intestinal adhesions. Successful patients with intestinal tuberculosis can see cellulose exudation and most gray-white tuberculous nodules on the serosal surface of the intestine, often causing occlusion of the intestinal wall vessels due to ulceration. At the same time, the surgical intestine wall often adheres to the adjacent intestinal tube or the greater omentum due to hyperplasia of the common fibrous tissue.
Other factors (10%):
Such as tumor invasive growth, destruction of surrounding international organizations, the formation of adhesions, or individual unexplained intestinal adhesions.
In clinical diseases, patients with intestinal adhesions often occur after the accumulation of surgery, especially after appendicitis or pelvic surgery, with the greatest chance of intestinal adhesions. The severity of intestinal adhesions is related to the sensitivity of each person to the damage to the peritoneal or intestinal serosal membrane.
Prevention
Intestinal adhesion prevention
Patients with intestinal adhesions should be more protective in their diet because of abnormalities in their intestinal morphology and function. Although the degree of adhesion and the degree of adhesion are different, the symptoms are more or less, and the condition is light and heavy. However, regardless of the change in intestinal adhesion due to intestinal adhesion, the intestinal tube is fixed to the posterior wall of the abdomen by means of the mesentery. The physiological structure has not changed. As long as the patient protects himself after taking a prone position, the intestines with food and the intestines without food can be kept in a clockwise state, which is beneficial to the food of the above intestines of the adhesion site slowly passing through the stenosis and safely entering the lower intestine of the adhesion site. The upper and lower intestines of the adhesion site have food, so that the pressure in the intestinal tube is balanced, and the intestinal tube containing the food will not be displaced, twisted and dumped, of course, the disease can be aggravated, and the intestines will not appear. obstruction.
Complication
Intestinal adhesion complications Complications intestinal fistula secondary suppurative peritonitis
May cause intestinal fistula, secondary suppurative peritonitis.
Symptom
Intestinal adhesion symptoms Common symptoms Abdominal distension abdominal pain Hernia exhaust disorder extensive and non-localized abdominal pain
The clinical symptoms of patients with intestinal adhesion may vary depending on the degree of adhesion and the site of adhesion. Light can be without any discomfort. Or occasionally mild abdominal pain, bloating, etc. after eating. Severe cases can often be accompanied by abdominal pain, bloating, poor ventilation, suffocation, dry stools, air stagnation in the abdomen, and even lead to incomplete obstruction.
Examine
Intestinal adhesion examination
(1) According to the relevant manifestations of chronic abdominal pain and recurrent episodes of mechanical intestinal obstruction.
(2) Indirect reflection according to images of limited intra-abdominal organ movement.
(3) According to the visual image of adhesion in the abdominal cavity.
(4) Laparoscopy.
(5) Visual inspection of abdominal cavity exploration.
(6) The clinical symptoms of patients with intestinal adhesion may vary depending on the degree of adhesion and the site of adhesion. Light can be without any discomfort. Or occasionally mild abdominal pain, bloating, etc. after eating. Severe cases can often be accompanied by abdominal pain, bloating, poor ventilation, suffocation, dry stools, air stagnation in the abdomen, and even lead to incomplete obstruction.
Diagnosis
Diagnosis of intestinal adhesion
1. Intestinal adhesion is caused by various reasons between the intestine and the intestine, between the intestine and the peritoneum, and between the intestine and the abdominal organ. There are two cases of membranous adhesion and cord-like adhesion in terms of adhesion characteristics, and there are two types of fibrin-like adhesion and fibrous adhesion from the nature of adhesion. Intestinal adhesion symptoms should be based on other symptoms to identify the degree of adhesion and adhesion sites.
2, the clinical symptoms of special patients with intestinal adhesion may be different due to the degree of adhesion and adhesion sites, light can be without any discomfort or occasionally mild abdominal pain after eating, such as abdominal distension, etc., severe cases can often be accompanied by abdominal pain, bloating, Poor exhaust, suffocation, dry stools, gas turbulence in the abdomen and even partial obstruction.
