Enteritis

Introduction to enteritis Intestinitis is an inflammatory manifestation caused by bacteria, viruses, fungi, and parasites. Clinical manifestations include abdominal pain, diarrhea, septic flushing or mucus pus and blood. Some patients may have fever and sensation after urgency, and they are classified into acute and chronic according to the length of the disease. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: enteritis acute enteritis

Cause of enteritis

Pathogenic bacteria (40%):

The etiology of this disease has not yet been fully elucidated. It is believed that the pathogenesis of this disease is related to the infection of the B-toxin-producing Welchii bacterium (C-type Clostridium perfringens), which can cause intestinal tissue necrosis and produce gangrenous enteritis. In the Papua New Guinea plateau where the incidence of this disease is high, the study found that the local residents have low levels of protease in the intestine, which is associated with a low-protein diet and a heat-resistant trypsin inhibitor (heatstable) contained in the local sweet potato. Trypsin inhibitors) related. In animal experiments, the animal is not pathogenic by perfusion of Welchii bacilli through the gastric tube; however, if the raw sweet potato powder or raw soybean powder containing trypsin inhibitor is simultaneously infused, it can cause disease and produce the same as acute hemorrhagic necrotic enteritis. Histopathological changes. Animal experiments have also demonstrated that trypsin-containing dog pancreatic extract can prevent and alleviate the occurrence and development of this disease.

Dietary factors (20%):

In addition to eating meaty foods contaminated with pathogenic bacteria, there are other dietary factors, such as sudden changes in eating habits, which are beneficial to the reproduction of Welchii bacilli; or diets such as sweet potato, intestinal trypsin inhibitor A large amount exists to reduce the destruction of B toxin.

Prevention of enteritis

Avoid eating meaty foods that are contaminated with pathogens. In addition, you should pay attention to your eating habits. Try not to use sweet potatoes as your main food.

Enteritis complications Complications enteritis acute enteritis

In severe cases, there may be complications such as shock, intestinal paralysis and other symptoms of poisoning and intestinal perforation.

Symptoms of intestinal inflammation Common symptoms Abdominal pain with diarrhea, bloating, fever, chills, nausea and vomiting

1, medical history: acute onset, a history of unclean diet before the onset, cold, tired, intestinal mites infection and malnutrition as predisposing factors.

2, abdominal pain: rapid onset, sudden abdominal pain, often can be the first symptom, mostly in the umbilical cord, often manifested as gradually increasing umbilical or mid-upper paroxysmal cramps, and then gradually changed to Perinatal persistent pain and paroxysmal aggravation.

3, diarrhea and blood in the stool: abdominal pain can occur after diarrhea, the stool is initially mushy and with fecal matter, then gradually yellow water-like, followed by white water or red bean soup and jam-like, even blood Shaped or dark red blood clots, less feces and stench, no urgency and heavy, the amount of bleeding is uncertain, light can only have diarrhea, or only fecal occult blood positive and no blood in the stool; severe cases of up to hundreds of milliliters a day, diarrhea and blood in the stool The short time is only 1 to 2 days, the elderly can reach more than one month, and may have intermittent episodes, or repeated episodes. Dehydration and metabolic acidosis may occur in severe cases of diarrhea.

4, nausea and vomiting: often with abdominal pain, diarrhea at the same time, vomit can be yellow water, coffee or bloody water, can also vomit bile.

5, systemic symptoms: systemic symptoms such as general malaise, weakness and fever can occur after onset, fever is generally 38 ~ 39 ° C, a few can reach 41 ~ 42 ° C, but fever more than 4 ~ 7 days gradually retreat, and continue Less than 2 weeks are rare.

6, abdominal signs: relatively few, sometimes abdominal fullness, see the intestinal type, umbilical and upper abdomen can have significant tenderness, early bowel sounds can be hyperthyroidism, and then can be weakened or disappeared.

Clinical typing

1, gastroenteritis type: seen in the early stages of the disease have abdominal pain, watery stools, low fever, may be associated with nausea and vomiting.

2, toxic shock: high fever, chills, apathy, lethargy, slang, shock and other performance, often occur within 1 to 5 days of onset.

3, peritonitis type: obvious abdominal pain, nausea and vomiting, abdominal distension and acute peritonitis signs, affected intestinal wall necrosis or perforation, abdominal bloody exudate.

4, intestinal obstruction type: There is abdominal distension, abdominal pain, frequent vomiting, defecation exhaust stops, bowel sounds disappear, there is a sac.

5, intestinal bleeding type: blood-like or dark red bloody stools, the amount can be as much as 1 ~ 2L, obviously anemia and dehydration.

Intestinal examination

1, blood

Peripheral leukocytosis, even as high as 4,000/mm3 or more, mainly due to neutrophil enlargement, often with nuclear left shift, red blood cells and hemoglobin are often reduced.

2, stool inspection

The appearance is dark red or bright red, or the occult blood test is strongly positive. A large number of red blood cells are seen under the microscope, and occasionally the mesenteric membrane is detached, and there may be a small amount or a medium amount of pus cells.

3, X-ray inspection

Abdominal plain film can show intestinal paralysis or mild, moderate intestinal dilatation, barium enema examination can be seen thickening of the intestinal wall, significant edema, colonic bag disappears, in some cases, there is gas between the intestinal wall, this sign is part of the intestinal wall Necrosis, colonic bacterial invasion; or ulcer or polypoid lesions and stiffness, in some cases, intestinal fistula, stenosis and cystic gas accumulation in the intestinal wall.

Diagnosis and identification of small intestine

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

The disease needs to be differentiated from toxic bacillary dysentery, allergic purpura, acute Crohn's disease, strangulated intestinal obstruction, intussusception, amoebic bowel disease and intestinal polyposis.

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