anal eversion
Introduction
Introduction Anal valgus is medically called rectal prolapse, or rectal prolapse, which refers to anal rectal valgus and prolapse outside the anus. More common in children under the age of 3, the incidence rate of men and women is equal, with age, more self-healing, with the improvement of medical technology and improved living standards, its incidence has declined.
Cause
Cause
The cause of rectal mucosal prolapse:
Prolapse of rectal mucosa is mainly related to inflammation of the antrum of the stomach. Malignant cell infiltration of the gastric mucosa can also occur. When the antrum is inflamed, the submucosal connective tissue is loose, and the gastric mucosa and submucosa proliferate. If the gastric antrum is enlarged, the mucosal folds are easily sent to the pylorus to form gastric mucosal prolapse. All the factors that can cause severe gastric peristalsis, such as mental stress, alcohol and tobacco, coffee stimulation, etc. are the causes of rectal mucosal prolapse.
There are currently two academic perspectives on the cause of rectal prolapse. One of the rectal mucosal prolapses is the slidability theory, and the other rectal mucosal prolapse is the intussusception theory. Two academic views on the etiology of rectal prolapse:
First, the slidability theory. It is considered that the depression formed between the rectum and the uterus of the patient (the male is the bladder) is too deep. When the pressure in the abdomen increases, the front wall of the rectum cannot withstand such pressure, and it will collapse into the abdomen of the rectum. For a long time, the rectum It will be released out of the anus to form a depression starting from the rectum uterus (or bladder). The rectum that is out of the anus is composed of the anterior wall of the rectum. This prolapse is mainly the anterior rectal wall and can form a severe rectal detachment. Drooping.
Second, the intussusception theory. It is believed that rectal prolapse is due to the fixation between the rectum and the sigmoid colon. It is damaged for some reason. When the intra-abdominal pressure continues to increase, the upper rectum and part of the sigmoid colon will be folded from the fixation to the lower rectum. Until the anus is removed, the anterior and posterior wall of the rectum are equal in length, and the rectum is prolapsed in the center of the intestine.
For a long time, there has been debate about the mechanism of formation of rectal mucosal prolapse. Some experts believe that the theory of slidability and intussusception is basically the same thing, but the degree of slidability can also be said to be an intussusception, but it does not affect the entire circumference of the intestinal wall. .
Examine
an examination
Related inspection
Anal finger examination anus visual anal reflex
1, common in physical deficiency of children and the elderly, or new maternal, or have a history of long-term diarrhea, cough, or a history of internal hemorrhoids.
2, out of the main symptoms of this card. When the light is defecation, the rectal mucosa is released, and then it can be repaid. Over time, it gradually develops into a full-thickness rectal prolapse. In addition to prolapse when taking a bowel movement, even coughing, walking, and squatting are also prolapsed. You must push back or rest in bed before returning. If the prolapse is not immediately repaid, rectal mucosa congestion and edema, bleeding or erosion. May be associated with perianal skin moist itching, lumbosacral and abdominal swelling and soreness. The prolapse time is slightly longer, and it is not reset in time, which can cause incarceration. The mucous membrane changes from pink to dark purple, even smashed and necrotic, swelling and pain, elevated body temperature, poor urination, heavy and heavy, and anal bulge pain.
3, need to be with the intensive intussusception from the anal prolapse and rectal polyps identification, rectal polyps can also be prolapsed by the anus, a small round smooth mass, must pay attention to intussusception sometimes can also be pulled out from the anus , like rectal prolapse III degree prolapse, such as finger examination, can touch the rectal anal canal and prolapsed intestinal mucosal reflex, according to the history and physical signs are not difficult to identify.
Diagnosis
Differential diagnosis
Differential diagnosis of anal valgus:
The symptoms of anal valgus are similar to those of internal hemorrhoids. Therefore, the anal valgus is often confused with the internal hemorrhoids in clinical practice. They are called prolapsed anal, but in fact there is a big difference between the two.
1 visual inspection:
The sputum exudate is a swollen and swollen mass, which is petal-like or ring-shaped, and there is bleeding. The normal mucosa is recessed between the nucleus.
The anal valgus excretion is rectum, with obvious radial longitudinal groove or rectal ring, pale or reddish, no bleeding.
2 finger diagnosis:
The internal hemorrhoids are prolapsed and the anal tightness is normal.
Anal valgus, the anal sphincter is significantly loose.
3 speculum check:
When the internal hemorrhoids were examined with a speculum, the size of the meat pieces that were petal-like and the mucosal bulge was different.
The anal valgus mucosa is annular and bulging, showing a uniform shape.
The anal valgus should be distinguished from the internal hemorrhoids. It is best to go to a professional anorectal hospital for a clear diagnosis and then take the corresponding treatment.
