Maroon skin or hair seen in feces

Introduction The clinical manifestations of enteropathic intestinal obstruction are similar to those of gallstone intestinal obstruction. Beginning with partial obstruction, complete intestinal obstruction can occur when the gut is moved to the end of the smaller ileum with intestinal peristalsis. Therefore, the obstruction site is also more common in the terminal ileum, and a few cases can be found in the duodenum, colon, rectum and other parts. Gastrointestinal bleeding can occur when the intestinal stone is rubbed or the intestinal mucosa is necrotic. It can also cause intestinal torsion, necrosis of the intestinal wall, and perforation to form diffuse peritonitis. Sometimes brownish red skin or hair can be seen in the vomit or feces.

Cause

(1) Causes of the disease

Primary intestinal intracholinthiasis may be due to excessive gastric acid secretion, lowering the pH of the proximal jejunum, or overgrowth of the bacteria in the intestinal fistula, causing the pH of the jejunum to decrease, and at the same time decomposing the bile salts to form bile acids. The lower pH jejunum is insoluble in water to form bile acid crystals. Cholic acid crystals can be used as the core of stones, and some insoluble or digested inorganic salts, foods or foreign bodies form special coagulum or lumps in the gastrointestinal tract, which become intestinal stones. Stones enlarge and block the small intestine, which leads to intestinal stones. Sexual intestinal obstruction.

(two) pathogenesis

According to the mixed components of intestinal stones, the intestinal stones that cause obstruction can be divided into three types:

1 true enteric stone: generally consists of a gut epithelium, small feces, fruit cores and other foreign matter constitute a core, formed by the deposition of inorganic salts.

2 drug-induced enteric stone: it is an insoluble lumps formed in the intestine after long-term oral administration of drugs containing calcium, phosphorus, magnesium, and the like.

3 mixed enteric stone (plant hairy stone): formed by the ingestion of certain fruits, vegetables or swallowed hair, especially the immature fruit is more easily formed.

Among the stones that cause intestinal obstruction, plant hairy stones are more common. Among them, phytoliths formed by persimmons are the most common. Immature persimmon pulp and mature persimmon skin contain tannic acid. When tannic acid is in contact with stomach acid, it forms a gelatinous polymer and precipitates. It continuously adsorbs plant fibers into agglomerates, and then passes inorganic substances containing calcium, phosphorus and magnesium. Salt deposition forms the gut stone. The more the amount of persimmon eaten, the easier it is to form. Hairy feces are more common in people with mental disorders who have swallowed themselves or others, animal hair, leaf fibers, wool coats, etc. More hair can be entangled with the gastrointestinal motility and become a strong, isolated mass. It has also been reported that the gastrointestinal anastomosis line partially falls off and forms a stone-induced intestinal obstruction.

Those with a history of gastric surgery, such as subtotal resection of Billroth II type anastomosis, vagus nerve cutting, pyloric angioplasty, etc. are more likely to form stones. Among the 113 cases of gastrointestinal stones reported by Michael, 106 cases had undergone stomach surgery. The reason is that after gastric surgery, the gastric peristalsis is slow and the emptying is delayed, so that the stomach contents are in contact with gastric acid for a long time, and it is easy to form stomach stones, especially after eating persimmons. After gastric surgery, especially Billroth II anastomosis, due to the larger anastomosis, the stomach stone formed in the stomach is more likely to enter the small intestine and cause obstruction. Intestinal stones are also easily formed at the intestinal diverticulum and at the proximal end of the intestinal stenosis.

an examination

Related inspection

Intestinal perforation, colonoscopy, enteroscopy, gastrointestinal disease, ultrasonography, enteroscopy

According to the medical history, combined with X-ray, endoscopy and B-ultrasound examination, the diagnosis is generally not difficult. However, those with atypical performance can only be diagnosed by surgery.

Differential diagnosis

The clinical manifestations of enteropathic intestinal obstruction are similar to those of gallstone intestinal obstruction. Beginning with partial obstruction, complete intestinal obstruction can occur when the gut is moved to the end of the smaller ileum with intestinal peristalsis. Therefore, the obstruction site is also more common in the terminal ileum, and a few cases can be found in the duodenum, colon, rectum and other parts. Gastrointestinal bleeding can occur when the intestinal stone is rubbed or the intestinal mucosa is necrotic. It can also cause intestinal torsion, necrosis of the intestinal wall, and perforation to form diffuse peritonitis. Sometimes brownish red skin or hair can be seen in the vomit or feces. Therefore, we should pay attention to the identification of the two.

According to the medical history, combined with X-ray, endoscopy and B-ultrasound examination, the diagnosis is generally not difficult. However, those with atypical performance can only be diagnosed by surgery.

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