Colonic bag semilunar fold disappearance

Introduction The early X-ray of ulcerative colitis showed the disappearance of the colonic pocket. On the inner surface of the colon, which corresponds to the transverse groove between the colonic pockets, the circumflex muscles are thickened, and the intestinal mucosa folds into the colonic meniscus. The disappearance of the colonic pocket is the paralysis of the mucosal myometrium, and the autoimmune-mediated tissue damage is ulcerative. One of the important factors in the pathogenesis of colitis. Some pathogens that invade the intestinal wall (such as E. coli, etc.) and human colonic epithelial cells have cross-antigens. When the body infects these pathogens, the autoantibodies in the circulation not only interact with the pathogens in the intestinal wall, but also kill their epithelium. cell. In recent years, a 40KD antigen has been found in the colonic epithelium of patients with ulcerative colitis, which activates the body to produce anti-colon epithelial antibodies and also activates complement and antigen-antibody complexes on the surface of the colon epithelium.

Cause

1. Immunological factors: People who hold this view believe that autoimmune-mediated tissue damage is one of the important factors in the pathogenesis of ulcerative colitis.

2. Genetic factors: Some data indicate that ulcerative colitis is closely related to genetic factors. The racial difference in Caucasians is significantly higher than in blacks, and Asians have the lowest incidence. Among them, the incidence of Caucasian Jews is 2 to 4 times higher than that of non-Jews, and about 50% less for people of color. The incidence of twin twins is higher than that of twins. At the same time, some authors reported an increase in tissue-associated antigen HLA-DR2 in patients with ulcerative colitis compared with normal subjects.

3. Mental factors: The role of mental factors in the pathogenesis of ulcerative colitis may be related to the autonomic dysfunction caused by mental disorders, leading to inflammation of the intestinal wall and ulcer formation. However, some authors have compared the patients with ulcerative colitis with the normal population and found no obvious mental incentives at the onset of the disease. On the contrary, after colectomy due to ulcerative colitis, the patient's original mental morbidity such as depression, anxiety, nervousness and suspicious symptoms were significantly improved. It seems that the mental factor is not the cause of the disease, more like the consequences of the disease.

an examination

Related inspection

Gastrointestinal CT examination

Ulcerative colitis can occur anywhere in the colorectal, more common in the rectum and sigmoid colon, but also in the ascending colon and other parts of the colon, or involving the entire colon. A small number of total colon involvement can invade the terminal ileum, and the affected intestinal tube is mostly limited to the terminal ileum within 10 cm from the ileocecal valve.

Differential diagnosis

(1) Initial hair style: Symptoms vary in severity, and there is no history of ulceration, which can be converted into chronic recurrent or chronic persistent type.

(2) Chronic recurrence type: The symptoms are mild, the most common in clinical practice, and there are often remission periods of different lengths after treatment. The peak of recurrence is mostly in spring and autumn, but less in summer. Colonoscopy in the onset of the colon, there are typical ulceration lesions, while the remission period only see mild congestion, edema, mucosal biopsy is chronic inflammation, easy to be mistaken for irritable bowel syndrome. Some patients can be converted to chronic persistent.

(3) Chronic persistent type: After the onset, there are often diarrhea, intermittent bloody stools, abdominal pain and systemic symptoms ranging from several weeks to several years, during which there may be an acute attack. This type of lesion has a wide range of lesions, and the colonic lesions are progressive, with many complications. The symptoms are severe in acute attacks and require surgical treatment.

(4) Acute fulminant: Domestic reports are few, accounting for 2.6% of the collapse, and foreign reports account for 20%. More common in adolescents, rapid onset, systemic and local symptoms are severe, high fever, diarrhea 20 to 30 times a day, blood in the stool, can cause anemia, dehydration and electrolyte imbalance, hypoproteinemia, weakness and weight loss, and easy to occur Toxic colonic dilatation, intestinal perforation and peritonitis often require urgent surgery and high mortality.

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