Deformation of the bowel
Introduction
Introduction The incidence of primary mesenteric tumors is not high, more common in men, male to female ratio of 3:2 or 2:1, can occur at any age, but the residual tumors of individual embryonic tissue are more common in children and adolescents, most Primary mesenteric tumors are derived from mesenchymal tissue and neural tissue, with the highest incidence of lymphosarcoma. Barium meal examination and barium enema angiography can indirectly show the location and size of the tumor, intestinal tube deformation and displacement.
Cause
Cause
Caused by chronic chronic inflammation and ulceration.
Examine
an examination
Related inspection
Gastrointestinal CT examination
Clinical manifestations are:
(1) Abdominal block
It is the earliest and most common symptom. It is often caused by abdominal discomfort or abdominal distension. It can also be caught by the abdominal mass. It is not consciously caught. More than the physical examination, the mass can be cystic or it can be substantive. If the quality is hard, the surface is not light, nodular and tender, often suggestive of malignant tumors.
(two) pain
It is also a common early symptom, mostly pain and discomfort. If the tumor invades the intestinal tract or the amphoteric tumor has a large degree of activity, which may cause partial intestinal obstruction, there is a pain, and the spontaneous rupture of the tumor may cause acute peritonitis and the like. Pain often prompts the patient to seek medical attention early.
(three) fever
More common in malignant tumors, the common initial symptoms of lymphosarcoma in many patients are unexplained fever. Some benign lymphangiomas have secondary infections and also have high fever. Highly malignant soft tissue sarcoma, rapid growth, secondary infection after partial necrosis and tumor toxin response can lead to irregular fever or low fever.
(4) Others
Such as poor appetite, weight loss, anemia, fatigue, etc. are all manifestations of some systemic reactions of malignant tumors. Blood in the stool or black feces indicates that the malignant tumor has invaded the intestinal tract and caused intestinal bleeding. Occasionally, mesenteric hemangioma is involved in intestinal mucosal bleeding. In addition, primary mesenteric malignant tumors first appear in the affected trachea of the metastatic lesions, such as chest tightness, chest pain when transferred to the lungs, headache, dizziness, etc. when transferred to the brain, and then found in the abdominal mass.
At the time of physical examination, benign tumors or tumors far from the mesenteric roots tend to move in the direction of the mesenteric roots. That is, those with small mesenteric origin have large left and right activities, and the upper and lower activities are small. The transverse mesenteric source has a large upper and lower activity, and there is activity. Small; sigmoid mesenteric source is mostly located in the lower abdomen, and its activity varies according to the length of the mesentery. Sometimes it is easy to push like an ovarian tumor, and sometimes it is more fixed. Very few malignant tumors with severe disease will have ascites and abdominal circumference increasing; abdominal venous engorgement, lower extremity and genital edema, etc., indicate that the inferior vena cava or iliac vein is compressed, causing blood circulation disorder. Tumors derived from the sigmoid mesenteric membrane, anal finger examination often can lick the tumor, and there may be symptoms such as poor urine and urine.
diagnosis
When a patient visits a patient, he or she can usually have a hernia and abdomen. If the medical history and other clinical manifestations are combined, it is not difficult to diagnose mesenteric tumors in the abdominal cavity. However, it is still necessary to cooperate with other tests to avoid misdiagnosis.
X-ray abdominal plain film can show a uniform density and deep block shadow, which is characterized by calcification, bone or tooth shadow, which indicates teratoma or low grade sarcoma. If there is an inflated image of the intestine, it indicates that the tumor compresses the intestine, or invades the intestinal wall into the intestine to cause incomplete intestinal obstruction. Barium meal examination and barium enema angiography can indirectly show the location and size of the tumor, deformation and displacement of the intestine. There is no tumor infiltration in the intestine. In general, the intestines shown by the angiography are curved around the tumor, and the extent and direction of the displacement from the intestine can be used to diagnose whether the tumor is from the small mesentery or the mesentery; when the tumor invades the intestinal wall, The intestinal tube shadow is stiff, the mucosal pattern becomes thick or interrupted, and the stenosis of the intestine can also be shown.
Ultrasound imaging can be diagnosed from tumor volume, boundary echo, envelope echo, and internal echo of the tumor. For the mesenteric cystic tumor, the liquid dark area is seen, the boundary echo is clear and there is obvious envelope echo and posterior enhancement effect. The benign tumor is small in size, the capsule is clear and complete, and the interior presents a uniform and rare hypoechoic area, sometimes or partially silent, such as lipoma, fibroids and social sheath tumor; the malignant tumor is large in volume and the interior is hypoechoic. The realm is also obvious, often suggesting low-grade malignant tumors, such as liposarcoma, fibrosarcoma, etc.; highly malignant tumor envelope echo area with or without, but the internal echo is different, uneven distribution, and there is no form The anechoic zone of the rule.
CT examination can not only identify tumors and retroperitoneal tumors of the abdominal cavity from the site where it occurs, but also detect a small volume of mesenteric tumor. The benign cyst has an outer envelope, and the intracapsular matrix exhibits a low density. Round, elliptical or irregular shapes may indicate lymphoid swelling. If there is calcification or ossification in the cyst, it should be indicated as a teratoma. Tumor or low grade soft tissue sarcoma. Mesenteric tumors with a higher degree of malignancy on CT images appear as soft tissue density shadows, and whether the surrounding tissues are invaded by them can be clearly seen. In particular, the relationship between the intestines and blood vessels and the tumor is very clear, which has high reference value for preoperative judgment and can be used for follow-up evaluation of treatment effects and understanding of recurrence.
Others such as lymphography, laparoscopic examination, etc. have a certain significance for the diagnosis of lymphosarcoma and the identification of ovarian tumors, but ultimately still follow the surgical exploration, so many do not advocate the use.
Diagnosis
Differential diagnosis
What needs to be identified is the omental tumor, which has a large degree of activity, but the downward movement is limited, and the site of occurrence is mostly in the shallow region of the central abdomen. The most difficult to identify is the mesenteric root tumor and retroperitoneal tumor, in addition to X-ray, CT can provide a little information, the diagnosis depends on surgical exploration.
