rectal stricture
Introduction
Introduction After rectal injury or inflammation, connective tissue hyperplasia in the intestinal wall, narrowing and narrowing the rectal cavity is called rectal stenosis. Most patients are 20 to 40 years old, and the incidence rate for males and females is 1..4. It occurs more than 2.5cm above the tooth line and the rectum ampulla. Most of the patients have anal pain, thin stools, and anal secretions. It varies according to the degree of stenosis. Severe stenosis is difficult to defecate after birth. It is manifested as crying during defecation, and signs of low intestinal obstruction may appear in days to months.
Cause
Cause
The motherland medicine believes that: this disease is a large intestine hot knot, poor airway, or related to mistreatment of trauma. Common reasons are:
1. Due to scar contracture after rectal surgery or excessive mucosal damage during surgery, such as internal hemorrhoidectomy, rectal anastomosis, rectal vaginal fistula surgery and other reasons.
2. Necrosis of the mucosa and intestinal wall due to corrosion of the drug, resulting in stenosis. Such as internal hemorrhoids, rectal injection, misuse of corrosive drug enema.
3. The rectum is scarred due to radiation therapy or burning damage, resulting in stenosis.
4. Due to secondary infection after rectal injury, scars are formed and stenosis occurs.
5. Congenital dysplasia and rectal inflammation and tissue hyperplasia due to various reasons, causing rectal stenosis. Such as proctitis, rectal, colonic schistosomiasis granuloma, amoebic granuloma, sexually transmitted lymphogranuloma.
6. Rectal stenosis caused by rectal tumors and compression of adjacent extracorporeal tissue masses. Such as prostate tumors, ovarian cysts, uterine tumors and so on.
Examine
an examination
Related inspection
Detection of glycolipid tumor markers in rectal examination
It is roughly the same as the anal stenosis. According to the medical history, digital or sigmoidoscopy, a diagnosis can be made.
At the time of the examination, the anal sphincter is found to be loose, the stenosis can be detected upwards, the rectal wall becomes hard, inelastic, and sometimes the stenosis is large or stenotic; the finger can be extended above the stenosis to distinguish it from a ring or a tube, inflammatory or Cancerous, but not too strong, so as not to cause pain, bleeding or tearing the intestinal wall. By speculoscopy, it can be seen that the mucosa under the stenosis becomes thicker, the stenosis is scorpion-like or ring-shaped, and the stenosis has feces or purulent discharge. At the same time, it is necessary to do an X-ray examination of tincture or lipiodol enema, determine the location and thickness of the rectal stenosis, and also check the bacteria, amoeba and schistosomiasis to determine the cause. It is best to do a biopsy, remove the cancer, and confirm the diagnosis.
Diagnosis
Differential diagnosis
Rectal stenosis needs to be identified as follows:
1, rectal stenosis has three different situations, need to identify each other.
(1) Annular stenosis: The rectal cavity is reduced from the periphery to the inside, forming a ring-shaped narrow, and the upper and lower narrow width is not more than 2 cm.
(2) Tubular stenosis: The rectal cavity is narrowed from the periphery to the inside, and the narrow region is longer, more than 2 cm, and becomes tubular.
(3) stenosis: a part of the rectal cavity is narrow, does not affect the entire circumference of the intestine, the narrow area is ? or semi-circular.
2, rectal stenosis also needs to be differentiated from anal stenosis.
Anal stenosis is the diameter of the anus and anal canal becomes smaller, the stool is difficult to pass, the stool is thinner, and the anus is painful during defecation. Objectively, the anus cannot pass through the index finger, and the anus stenosis has congenital and acquired stenosis. Congenital anal stenosis is an anal congenital malformation, and acquired anal stenosis is mostly caused by inflammation of the anal area.
