Intestinal perforation in amebiasis
Introduction
Introduction to amebic disease intestinal perforation Ulcers of intestinal amebiasis are generally superficial, but when the infection is severe, deep ulcers may occur and intestinal perforation may occur, which occurs in patients with fulminant symptoms and has a high mortality rate. Perforations are often large, mostly in the cecum, appendix, and ascending colon, followed by the rectal sigmoid junction. The perforations can be single or multiple. basic knowledge The proportion of illness: 0.012% Susceptible people: no specific population Mode of infection: digestive tract spread Complications: amoebic liver abscess
Cause
Etiology of amebic disease intestinal perforation
Cause
Intestinal amebiasis.
Pathophysiology
Ulcers of intestinal amebiasis are generally superficial, but when the infection is severe, deep ulcers may occur and intestinal perforation may occur, which occurs in patients with fulminant symptoms and has a high mortality rate. Perforations are often large, mostly in the cecum, appendix, and ascending colon, followed by the rectal sigmoid junction. The perforations can be single or multiple.
Prevention
Amoebic disease intestinal perforation prevention
1, early treatment, isolation of patients, good patient sterilization. Chronic patients should be treated promptly. If they are diet workers, they should not be exposed to diet work for the time being.
2, pay attention to drinking water, food hygiene, fruit and raw vegetables to wash, develop the habit of washing hands before and after meals.
3, during the medication should be regularly reviewed feces, adjustment treatment, in order to completely cure.
4, those with amoeba must be treated, especially with children with cohabitation should be actively treated to remove the pathogen.
5. Health education should be strengthened in popular areas to eliminate the breeding grounds of flies and cockroaches and strengthen the management of water sources.
Complication
Amoebic disease intestinal perforation complications Complications amoebic liver abscess
1, intestinal bleeding: the incidence of less than 1%, can generally occur in patients with amoebic dysentery or granulomatosis, due to ulcer invasion of the intestinal wall blood vessels, a large number of bleeding per ulcer caused by the submucosal layer, invading large blood vessels, or Caused by the destruction of granuloma, a large number of bleeding is rare, but once it occurs, the condition is critical, often caused by shock, and a small amount of bleeding is caused by superficial ulcer bleeding.
2, extraintestinal complications: amoeba trophozoite can spread from the intestine through the blood flow a lymphatic spread of distant organs and cause a variety of extraintestinal complications, of which liver abscess is common, followed by lung, pleura, pericardium, The brain, peritoneum, stomach, gallbladder, skin, urinary system, and female reproductive system can all be invaded.
Symptom
Amoebic disease intestinal perforation symptoms common symptoms intestinal perforation abdominal pain diarrhea intestinal bleeding high fever
Mainly due to abdominal pain and peritonitis.
Examine
Examination of intestinal perforation of amebic disease
For patients whose primary disease has not been diagnosed, rectal examination such as ulceration of the proximal mucosa of the rectum, pus and blood secretions on the fingertips, should be used as a smear to find amoeba trophozoites. If the intestinal perforation is found to be large during surgery, there are gray-white necrotic tissue on the intestinal mucosa, or flaky necrosis of the intestinal wall, especially in the cecal, ascending colon, sigmoid colon and other areas where amebiasis occurs, and the intestinal content should also be taken. Use the swab as a smear on the ulcer surface to check the amoebic trophozoite, which is helpful for diagnosis. If the intestinal perforation is small, or the process of perforation is slow, the adhesion is gradually formed around the lesion. Localized abdominal infections and abscesses are easily misdiagnosed.
Diagnosis
Diagnosis and differential diagnosis of amebic disease intestinal perforation
A patient who has been diagnosed with amoebic dysentery is not difficult to diagnose when sudden abdominal pain and peritonitis appear.
