Neurogenic ileus syndrome
Introduction
Introduction to neurogenic intestinal obstruction syndrome Neuropathic Intestinal Obstruction is also called sputum intestinal obstruction, functional intestinal obstruction, dynamic intestinal obstruction, and Shelshmiski disease. The intrinsic is first described by the Soviet physician Chercherski and is also known as Chercnerski disease. There are also a few cases reported in China, and the actual intrinsic is not uncommon. Neurogenic intestinal obstruction can be divided into paralytic and spasmodic. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: acute diffuse peritonitis
Cause
Causes of neurogenic intestinal obstruction syndrome
Paralytic (30%):
Due to the inhibition of muscle movement in the intestinal wall and the loss of peristaltic ability, the contents of the intestine can not be operated downward, seen in acute diffuse peritonitis, retroperitoneal hemorrhage or infection. The bowel sounds of paralytic ileus are extremely weakened or disappeared.
(30%):
Intestinal wall muscles are strong and contracted, often due to trauma or inflammation inside and outside the intestinal cavity, foreign body stimulation and other effects, abdominal pain of paralytic intestinal obstruction is mild, mainly manifested as no defecation or exhaust, severe abdominal distension, can cause respiratory and heartbeat to accelerate As well as oliguria, there may be no systemic symptoms in the early stage of intestinal obstruction. When accompanied by repeated vomiting, dehydration and electrolyte imbalance may occur.
Prevention
Prevention of neurogenic intestinal obstruction syndrome
There are many causes of stalk intestinal obstruction. Children with tsutsugamushi disease who are able to prevent it should actively deworming treatment. Those who have sputum should be repaired in time. The operation during abdominal operation is gentle. It is reported that carboxymethyl fiber is placed in the abdominal cavity after operation. Sodium carboxymethyl cellulose and oral vitamin E can reduce the incidence of intestinal adhesions.
Complication
Complications of neurogenic intestinal obstruction syndrome Complications, acute diffuse peritonitis
(1) Acute diffuse peritonitis, retroperitoneal hemorrhage or infection, incarcerated external hemorrhoids or internal hemorrhoids.
(2) Incarcerated external hemorrhoids or internal hemorrhoids.
Symptom
Symptoms of Neurogenic Intestinal Obstruction Syndrome Common Symptoms Fecal vomit constipation Abdominal bloating over water Acoustic abdominal pain with nausea, vomiting, bowel sounds, cessation of exhaustive paroxysmal colic, abdominal muscle tension, persistent colic
1. Paralytic: Due to the inhibition of muscle movement in the intestinal wall and the loss of peristaltic ability, the contents of the intestinal lumen cannot be operated downward, as seen in acute diffuse peritonitis, retroperitoneal hemorrhage or infection.
2. : The abdominal pain of paralytic ileus is mild, mainly manifested as no defecation or deflation, severe abdominal distension, which can cause rapid breathing and heartbeat and oliguria. In the early stage of intestinal obstruction, there may be no systemic symptoms, and when accompanied by repeated vomiting, dehydration and electrolyte imbalance may occur. The bowel sounds of paralytic ileus are extremely weakened or disappeared.
Examine
Examination of neurogenic intestinal obstruction syndrome
Abdominal fluoroscopy or radiography examination, if the presence of gas and liquid level in the small intestine is found, the content of the soup passes through the obstacle, suggesting the possibility of intestinal obstruction, but there is no obvious X-ray sign of intestinal obstruction in the early stage of the disease. Should be especially vigilant.
Diagnosis
Diagnosis and differentiation of neurogenic intestinal obstruction syndrome
diagnosis
By detailed medical history and physical examination, most of the diagnosis is not difficult. When the diagnosis is difficult, it is feasible to perform abdominal X-ray or radiograph examination. If there is gas and liquid level in the small intestine, it is the content of the soup passing through the obstacle. It is suggested that there may be intestinal obstruction, but the X-ray signs of obvious intestinal obstruction in the early stage of the disease should be particularly vigilant. Therefore, the diagnosis of this disease is mainly based on clinical manifestations and must not be determined or denied by X-ray examination alone.
Differential diagnosis
1. Chronic intestinal pseudo-obstruction
2, chronic intestinal pseudo-obstruction (chronic intestinal pseudo-obstruction)
It is a syndrome with signs and symptoms of intestinal obstruction but no evidence of mechanical obstruction. Paralytic ileus is acute intestinal pseudo-obstruction. It is believed that the intrinsic condition is the result of neurodegeneration of the intestinal wall. The symptoms of the patient are often children or puberty, and a few are present at the age of one. The course of the disease is usually repeated with acute exacerbation and remission. Symptoms and mechanical obstruction at the time of attack are similar. Unequal nausea, vomiting, colic, abdominal pain, diarrhea or steatorrhea, and abdominal tenderness; no or only mild symptoms such as bloating during remission. Intestinal pseudo-obstruction can affect the whole digestive tract, or an isolated organ, such as the esophagus, stomach, small intestine or colon, etc. Among them, the symptoms of small intestinal obstruction are most obvious, such as simple involvement, the intestine can be expressed as giant. The finger is often accompanied by a large amount of vomiting and weight loss. It is easily misdiagnosed as superior mesenteric artery syndrome. For example, only the colon is involved in chronic constipation and repeated fecal block plugging. In some cases, there is a bladder empty disorder.
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