Gastric crisis

Introduction One of the manifestations of syphilis is that spinal cord spasm causes multiple visceral crises, with gastric crisis being common. Syphilis of stomach is a rare stomach disease caused by the invasion of the stomach wall by Treponema pallidum.

Cause

(1) Causes of the disease

Gastric syphilis is caused by the invasion of syphilis spirochetes.

(two) pathogenesis

The lesion begins in the lower layer of the gastric mucosa. Early syphilis can cause the stomach wall to be involved, but most of them are transient, and the pathological changes of the second stage syphilis gastric mucosa are not specific. Gastric lesions are mainly caused by stage III syphilis, which is characterized by inflammatory infiltration and formation of gum-like swelling, single or multiple, histological granuloma changes, visible central necrotic lesions surrounded by epithelial cells, fibroblasts and giant cells. . Pathogens can be seen by silver staining or fluorescein-labeled antibody staining in the dark field, and can also be found by immunization. The inflammatory infiltrate is mainly composed of the submucosa, and the muscle layer can also be thickened. The surface of the lesion is smooth and the color is dark. It can also form a typical gum swelling and superficial nodules in the stomach wall, and then collapse into ulcers. When exposed, there is a feeling of induration, which forms scars or penetrates the stomach wall.

an examination

Related inspection

Fiber endoscopy, serous effusion, serous effusion, cell count

Symptoms develop more slowly, but progressively worsen, as the volume of the stomach shrinks and the ulcers become more pronounced. At first, it manifested as pain or discomfort in the upper abdomen after a meal. Accompanied by upper abdominal distension, nausea, vomiting and weight loss, fatigue and so on. Abdominal pain and vomiting are aggravated by the formation of gastric scars and obstruction of pyloric passage. Some patients have symptoms similar to peptic ulcers. In a few cases, the abdominal examination can touch the mass.

Gastric syphilis has no specific symptoms and is difficult to diagnose. It is helpful to confirm the diagnosis based on past disease history, early syphilis sputum history, gastric X-ray examination and serum antigen reaction. Gastroscopic findings and biopsy are consistent with the pathological changes of syphilis, and the diagnosis can be confirmed. After anti-syphilis treatment, X-ray barium meal imaging of the stomach shows that the lesion is improved or disappeared, which is helpful for diagnosis.

Differential diagnosis

Stomach syphilis is sometimes difficult to distinguish from gastric cancer and gastric ulcer. However, gastric syphilis occurs mostly in young patients who have not been treated with anti-syphilis. The course of disease is longer and the weight loss is slower than that of gastric cancer. Sometimes it is necessary to undergo biopsy or postoperative pathological examination to confirm the diagnosis.

Symptoms develop more slowly, but progressively worsen, as the volume of the stomach shrinks and the ulcers become more pronounced. At first, it manifested as pain or discomfort in the upper abdomen after a meal. Accompanied by upper abdominal distension, nausea, vomiting and weight loss, fatigue and so on. Abdominal pain and vomiting are aggravated by the formation of gastric scars and obstruction of pyloric passage. Some patients have symptoms similar to peptic ulcers. In a few cases, the abdominal examination can touch the mass.

Gastric syphilis has no specific symptoms and is difficult to diagnose. It is helpful to confirm the diagnosis based on past disease history, early syphilis sputum history, gastric X-ray examination and serum antigen reaction. Gastroscopic findings and biopsy are consistent with the pathological changes of syphilis, and the diagnosis can be confirmed. After anti-syphilis treatment, X-ray barium meal imaging of the stomach shows that the lesion is improved or disappeared, which is helpful for diagnosis.

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