Congenital long colon

Introduction to congenital long colon Congenital long colon (congenitaldolichoclon) also known as sigmoid colon polychaemia (dolichasigmoid), the colon consists of the cecum, ascending colon, transverse colon, descending colon and sigmoid colon, and the rectum is composed of six parts, the ascending colon, the descending colon and the lower rectum are the interperitoneal space or The external organs are relatively fixed and cannot be lengthy. The cecum and transverse colon are long. They may cause abdominal pain, abdominal distension and other digestive symptoms due to excessive activity. The sigmoid colon is a stool storage organ. The sigmoid colon can cause chronic constipation. In the 1950s and 1970s, The former Soviet medical journal often publishes articles about the disease. basic knowledge The proportion of sickness: 7.6% Susceptible people: children Mode of infection: non-infectious Complications: nausea and vomiting

Congenital long colon cause

(1) Causes of the disease

Some authors examined 3 cases of intestinal ganglion cells in children with sigmoid stenosis, 2 of which were normal, 1 was reduced, and chronic constipation caused by sigmoid colon. There may be 2 reasons: one is primary (HDAD); one is continued Hair (simple length), the cause of sigmoid colon lengthy remains to be further studied.

(two) pathogenesis

Kusi (1967) dynamically observed more than a thousand cases of chronic constipation and frequent abdominal pain, found that 25% of the sigmoid colon is long; Trofimova (1968) examined more than a thousand cases of chronic constipation, 30% to 40% of the sigmoid colon is verbose, also has sigmoid colon It is lengthy, why is there a completely healthy child, and some are chronic constipation? Lyonyushkin believes that the sigmoid length is not only the pathological basis for clinical symptoms, but also the normal variation, that is, no clinical symptoms.

Klimanov (1973) studied the histological findings of the sigmoid colon length, intestinal wall muscle fibrosis with connective tissue edema, lymphocyte infiltration based on muscle fiber hypertrophy, intestinal mucosal atrophy, lymphatic space widening, no change in plexus, but ganglion The number of cells is reduced, the nucleus shrinks, and vacuoles. The changes in the synapses at the distal end of the sigmoid colon under electron microscopy are primary lesions. The above changes are in line with the pathological changes of congenital megacolon homologous disease (HAD).

Congenital long colon prevention

1, early pregnancy, avoid fever and cold. Women who have had high fever in early pregnancy, even if the child does not have obvious appearance deformity, brain tissue development may be adversely affected, manifested as mental retardation, poor learning and reaction ability, this mental retardation can not be restored. Of course, fetal fever caused by high fever is also related to the sensitivity of pregnant women to high fever and other factors.

2. Avoid getting close to dogs and cats. Few people know that cats with bacteria are also a source of infectious diseases that are a great threat to fetal malformation, and cat feces are the main route of transmission of this malignant infectious disease.

3. Avoid women who wear makeup every day. The survey shows that the incidence of fetal malformations in heavy makeup is less than 1.25 times that of heavy makeup. The main adverse effects on fetal malformation are arsenic, lead, mercury and other toxic substances contained in cosmetics, which affect the normal development of the fetus. Secondly, some of the ingredients in the cosmetics are exposed to ultraviolet rays in the sun to produce teratogenic aromatic amine compounds.

4, to avoid mental stress during pregnancy. Human emotions are controlled by the central nervous system and the endocrine system. One of the endocrine corticosteroids is closely related to human mood changes. When pregnant women are emotionally stressed, adrenocortical hormone may block the fusion of a certain tissue of the embryo. If it occurs during the first 3 months of pregnancy, it will cause malformations such as cleft lip or palate.

5. Avoid drinking alcohol. Pregnant women drink alcohol, alcohol can enter the developmental embryo through the placenta, causing serious damage to the fetus. Such as a small head, very small ear and nose and a wide upper lip.

6, avoid eating mold and vegetarian food. Experts pointed out that if pregnant women eat food contaminated with mycotoxin (mildew food), mycotoxins can cause fetal chromosome breaks in the fetus through the placenta.

The prognosis of intestinal atresia is related to the position of atresia, and the survival rate of simple atresia, distal jejunum and proximal ileum is high. In recent years, the mortality rate of intestinal atresia has decreased significantly. The domestic survival rate is 51.3%~73.3%, and the foreign country is about 70%-85%. Low birth weight, with other malformations, has a lower survival rate.

Congenital long colon complications Complications, nausea and vomiting

Congenital long colon with enteritis will occur local and systemic infection toxic symptoms, and even megacolon crisis, delayed treatment can cause intestinal perforation, peritonitis, sepsis due to severe abdominal distension, the disease will rapidly deteriorate, and eventually die.

The megacolon crisis refers to the difficulty of long-term progressive defecation, which causes a large amount of feces to accumulate in the colon of the dilated segment. The harmful substances in the feces are absorbed into the human blood, leading to bloating, vomiting, water and electrolyte disturbance, high fever, shock, and even death. A serious complication.

Congenital long colon symptoms Common symptoms Constipation Abdominal distension Abdominal pain Abdominal pain Nausea and vomiting

Some cases are similar to congenital megacolon, and some are secondary chronic constipation.

In Lyonyushkin's data, 60% of children with sigmoid stenosis, constipation occurred in breastfeeding within 1 year of age and turned to artificial feeding or supplementary food supplementation; 40% of constipation occurred in 3 to 6 years old, due to accumulation of intestinal contents, fullness And the curvature or partial torsion of the intestinal fistula, the mesentery has adhesions or scars, and abdominal pain, sometimes abdominal pain accompanied by vomiting. The author dynamically observed 3 to 14 years old children, the clinical manifestations of sigmoid colon severance were divided into compensation, subgeneration Reimbursement and decompensation for 3 issues.

Compensation period: characterized by occasional intestinal dysfunction, X-ray examination found that the sigmoid colon is lengthy, actually for healthy children, some complained of occasional lower abdominal pain, some abdominal pain with vomiting, abdominal distension, some suspected appendicitis and surgery, postoperative Abdominal pain is not relieved, and the development of this period of children is consistent with the same age, without any signs.

Sub-compensation period: The main symptom is intermittent constipation, that is, it is repeated once every 2 to 3 days. Many parents confirm that symptoms appear after 2 years old, which may be related to the amount of fruits and vegetables in food, and the frequency of constipation in winter and spring. Hair, constipation relief in summer and autumn, the characteristics of this period of sickness are often abdominal pain and bloating, often with fecal accumulation along the colon, so parents often use laxatives.

Decompensation period: This period is characterized by more obvious intestinal dysfunction, constipation for more than 5 days, some sick children can not spontaneously defecate, only after enema can defecate, and sometimes lower abdomen enlargement (flatulence).

Some of the above symptoms are similar to congenital megacolon, but the extent is completely different: the clinical manifestations of sigmoid colon stagnation are milder, and the onset is later, often with constipation and spontaneous bowel movements alternating.

Congenital long colon examination

Abdominal x-ray standing plain film: routine examination, the initial location of the lesion, the severity of the lesion and the possible prognosis.

Lower gastrointestinal sputum angiography: There are likely to cause radiation damage, and it is still widely used clinically. It is also one of the most important and accurate inspection methods. Contrast examination can clearly diagnose the location, extent of the lesion, the condition of the dilatation of the intestine and the situation of sputum excretion, and contribute to the relevant differential diagnosis.

Ultrasound examination of the abdomen: Ultrasound examination has developed rapidly in recent years, and has partially or completely replaced the diagnostic functions of large-scale auxiliary instruments such as traditional angiography and tomography. The ultrasonic examination method is simple, the equipment requirements are low, the objectivity is strong, and it is harmless to the body, but Ultrasound doctors are required to have extensive clinical experience and certain surgical anatomy expertise, which can be done by non-specialist hospitals and ultra-specialized ultrasound doctors. This year, our hospital has made a large number of accurate clinical diagnoses through simple outpatient ultrasound.

Rectal manometric examination: It is widely used in foreign countries and Hong Kong and Taiwan. The content of pressure measurement is internal sphincter relaxation reflex and pressure changes in various parts of the anal canal. This method is safe and simple, but requires large and expensive medical equipment, subject to subjective judgment by operators. The impact of the results, the results of the examination results are not strong, there is a certain error rate, especially the accuracy of newborns and small babies.

Rectal mucosal biopsy and enzymology: clinically used physical examination and radiological examination methods can not accurately determine the cause of the disease can be considered for rectal mucosal biopsy and enzymology examination, the method is accurate, objective, reliable, but invasive examination Therefore, it is often forced to adopt it in clinical work.

Diagnosis and diagnosis of congenital long colon

Diagnosis of sigmoid colon lengthy, based on careful study of clinical manifestations and X-ray barium enema data, and to determine the clinical stage of the disease, Lyonyushkin believes that sigmoid colon schizophrenia in the early stage of the sigmoid colon expansion, so the giant sigmoid colon, giant sigmoid colon Symptoms and the like are only further dysfunction and morphological changes in sigmoid colonic length.

The children diagnosed with sigmoid colon lengthening should be observed dynamically. The number of reexaminations per year: 1 compensation period, 2 sub-compensation periods, and 3 decompensation periods.

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