ileal duplication
Introduction
Introduction Duplication of small intestine is a small or tubular structure of the hollow intestine that appears in the mesenteric side of the small intestine. It has the same tissue as the adjacent small intestine. Structure, its blood supply is also very close. Recurrent intestinal malformations can occur in any part of the small intestine, but are most common in the ileum.
Cause
Cause
There are many theories about the causes of repeated intestinal malformations, but each theory cannot comprehensively solve the causes of repeated deformities in various parts. The cause may be multi-sourced, and the causes of different parts and different pathological changes may be different.
1. The original intestinal dysfunction theory After the 5th week of embryo, the rapid proliferation of epithelial cells in the original intestinal lumen caused temporary occlusion of the intestinal lumen. Later, the epithelial cells that occluded the intestinal lumen showed many vacuoles, which made the occluded intestinal lumen. Also connected, that is, the cavity period. In this case, developmental disorders occur, and there is a parallel interval between the intestines and the digestive tract, which may form a repeat cyst of the intestinal cyst.
2. The diverticulum-like outer bag learns that the embryos are 8 to 9 weeks old, and the epithelial cells covered by the connective tissue at the distal end of the small intestine bulge outward to form a temporary suffocation-like outer bag, which gradually disappears. If left, the original diverticulum-like outer bag can develop into a cystic small intestine repeat deformity.
3. Notochord - Protozoal Separation Disorders The embryo has a notochord between the inner and outer ectoderm at 3 weeks. In this case, there is an abnormal adhesion between the inner and outer ectoderm, and the notochord is divided into two parts at the left and right portions, wherein the notochord and the vertebral body form a cord-like nerve intestinal tube through the ectoderm and the digestive tract. When the endoderm develops into the intestine later, the intestine tube portion pulled by the strip-like adhesion forms a diverticular bulge to the dorsal side, which can later develop into a repeat deformity. Since adhesions occur on the dorsal side of the original intestine, repeated deformities are also located on the mesenteric side. Adhesive cords can affect the development of the vertebral body, so this repeated deformity is often accompanied by vertebral body malformations, such as hemivertebra and butterfly. Li Long et al. divided the intestinal duplication into 2 types, while the mesenteric repeated malformed intestines were located between the two lines, 91.6%. Combined thoracic deformity, and proposed this type is due to the separation of the notochord and the original intestine.
4. Intestinal ischemic necrosis theory In recent years, many scholars have studied that after the development of the primitive gut, changes in intestinal atresia, stenosis and short intestine occur due to ischemic necrosis of the original intestine. The intestinal tube fragments remaining after necrosis are supplied from nearby blood vessels and can develop into repeated deformities. Therefore, some children with small bowel repeat deformity can be accompanied by intestinal atresia, stenosis and short bowel deformity.
Examine
an examination
Related inspection
Ectopic gastric mucosa imaging anti-retinin antibody plasma cells
Preoperative diagnosis is not easy, and often diagnosed due to complications of emergency laparotomy. The literature reported that the preoperative diagnosis rate was only 15.3% to 45.7%. The smaller the deformity cyst, the lower the preoperative diagnosis rate. Therefore, in the case of children under the age of 2, there are unexplained abdominal pain, blood in the stool, incomplete or complete intestinal obstruction, especially in the abdominal cavity to cystic mass should consider small intestinal repeat deformity. Abdominal X-ray films show a uniform density of cyst shadows, or filling and defect of small bowel tincture, compression, tubular or diverticulous tincture filling outside the small intestine, and spinal deformity have diagnostic value.
Diagnosis
Differential diagnosis
Tuberculosis in the ileocecal area: tuberculosis in the ileocecal area is caused by tuberculosis infection! Intestinal tuberculosis is the most common type of tuberculosis in the digestive system The vast majority are secondary to extraintestinal tuberculosis, especially hollow tuberculosis. According to statistics, 25% to 50% of tuberculosis patients can be complicated by intestinal tuberculosis. The source of intestinal tuberculosis is mainly ingestive, caused by swallowing sputum containing tubercle bacilli, occasionally from food contaminated by tuberculosis, or directly from blood-borne or abdominal, pelvic other organs spread. The age of onset is mostly young and middle-aged, with more women than men, about 1.85:1. Pathologically divided into ulcer type, proliferative type and mixed type. Preoperative diagnosis is not easy, and often diagnosed due to complications of emergency laparotomy. The literature reported that the preoperative diagnosis rate was only 15.3% to 45.7%. The smaller the deformity cyst, the lower the preoperative diagnosis rate. Therefore, in the case of children under the age of 2, there are unexplained abdominal pain, blood in the stool, incomplete or complete intestinal obstruction, especially in the abdominal cavity to cystic mass should consider small intestinal repeat deformity. Abdominal X-ray films show a uniform density of cyst shadows, or filling and defect of small bowel tincture, compression, tubular or diverticulous tincture filling outside the small intestine, and spinal deformity have diagnostic value.
