Abdominal "flexibility" sign
Introduction
Introduction Abdominal flexibility is caused by mild stimulation or chronic inflammation of the peritoneum. It can be seen in various types of tuberculous peritonitis, but it is generally considered to be a clinical feature of adhesion-type tuberculous peritonitis. Most patients have different degrees of tenderness, generally mild, a small number of tenderness and rebound tenderness, the latter more common in cheese type.
Cause
Cause
The majority of tuberculous peritonitis is secondary to tuberculosis in other organs. The path of infection of this disease can be directly spread by intra-abdominal tuberculosis or disseminated by blood. The former is more common, such as intestinal tuberculosis, mesenteric lymphatic tuberculosis, tubal tuberculosis, etc., can be the direct primary lesion of the disease. More women than men may be due to retrograde infection of pelvic tuberculosis.
Examine
an examination
Related inspection
Esophageal X-ray barium meal examination laparoscopy
Inspection and diagnosis:
1, young and middle-aged patients have unexplained fever, lasting more than two weeks, accompanied by night sweats, by ordinary antibiotic treatment is invalid.
2, there is a history of close contact with tuberculosis or I have other extraintestinal tuberculosis of tuberculosis.
3, the abdominal wall is flexible, there are ascites or can touch the mass.
4, ESR increased, ascites is exudate.
5, X-ray gastrointestinal barium meal examination found signs of intestinal adhesions.
Diagnosis
Differential diagnosis
Identification:
1. Identification of diseases with ascites
1 cirrhosis decompensation, patients with liver function abnormalities, portal hypertension, spleen hyperactivity, liver disease face and spider mites and other performance. Ascites is a leaking liquid. Typical cases are not difficult to identify, but patients with cirrhosis and ascites should sometimes be treated with tuberculous peritonitis;
2 cancerous ascites is mostly bloody ascites, repeated ascites examination can find tumor cells;
3 other constrictive pericarditis, hepatic vein occlusion syndrome can produce ascites, but both have corresponding pericardial and liver signs, ascites stubbornly difficult to eliminate.
2. Identification of diseases with fever as the main performance
Tuberculous peritonitis needs to be differentiated from typhoid fever when there is heat retention. Typhoid fever often has apathy, relatively slow pulse, serum widal and reaction and blood culture positive.
3. Identification of diseases with abdominal pain as the main symptom
Should pay attention to the identification of diseases such as Crohn's disease, chronic cholecystitis, chronic appendicitis, peptic ulcer, ectopic pregnancy. When combined with intestinal obstruction, perforation and peritonitis, it should be differentiated from acute abdomen caused by other causes.
4. Identification of diseases with abdominal mass as the main sign
The disease is sometimes confused with malignant tumors such as ovarian cysts, colon cancer, and ovarian cancer, and attention should be paid to identification.
diagnosis:
Typical case diagnosis is generally no difficulty, the main basis is:
1. Young and middle-aged patients have fever of unknown cause, lasting for more than two weeks, accompanied by night sweats, and are not effective after general antibiotic treatment.
2. There is a history of close contact with tuberculosis or other tuberculosis of tuberculosis;
3, the abdominal wall is flexible, there are ascites or can touch the mass.
4, ESR increased, ascites is exudate.
5, X-ray gastrointestinal barium meal examination found signs of intestinal adhesions.
