Umbilical paroxysmal colic

Introduction Sudden onset of severe abdominal pain continues unabated, or from paroxysmal colic to persistent abdominal pain, the site of pain is more fixed, if the abdominal pain involves the back to suggest that the mesentery is pulled, it is more suggestive of strangulated intestinal obstruction. Intestinal obstruction caused by agglomerated foreign bodies or fecal blocks is not common. Large gallstones have been reported through the gallbladder or common bile duct - the intestinal fistula into the intestine, and cases of gallstone intestinal obstruction have been reported. Even the adhesion to the adhesion zone can cause the intestinal fold to twist and cause obstruction. Congenital adhesions are more common in children; adhesions caused by abdominal surgery or intra-abdominal inflammation are the most common causes of intestinal obstruction in adults, but in a few cases there is no history of abdominal surgery and inflammation.

Cause

Parenteral causes:

(1) Adhesion and adhesion of the adhesion zone can cause the intestinal fold to twist and cause obstruction. Congenital adhesions are more common in children; adhesions caused by abdominal surgery or intra-abdominal inflammation are the most common causes of intestinal obstruction in adults, but in a few cases there is no history of abdominal surgery and inflammation.

(2) Incarcerated external hemorrhoids or internal hemorrhoids.

(3) Intestinal torsion is often caused by adhesion.

(4) Extraintestinal tumor or abdominal block compression.

The cause of the intestine itself:

(1) Congenital stenosis and obturator deformity.

(2) Inflammation tumor anastomosis and other factors caused by stenosis. For example, inflammatory bowel disease, intestinal tuberculosis, radiation damage, intestinal tumors (especially colon tumors), intestinal anastomosis, and the like.

(3) Intussusception is less common in adults, mostly caused by polyps or other intestinal lesions. .

Intestinal cavity causes:

Intestinal obstruction caused by agglomerated foreign bodies or fecal blocks is not common. Large gallstones have been reported through the gallbladder or common bile duct - the intestinal fistula into the intestine, and cases of gallstone intestinal obstruction have been reported.

an examination

Related inspection

Abdominal plain film

Symptoms and signs Typical intestinal obstruction is not difficult to diagnose, but lack of typical performance is more difficult to diagnose. X-ray abdominal fluoroscopy or radiography is helpful in confirming the location of the clinical diagnosis to determine intestinal obstruction. Normal people can only see a small amount of gas in the stomach and colon on the X-ray film. For example, there is a gas and liquid level in the small intestine indicating that the contents of the intestine pass through the obstacle, suggesting the presence of intestinal obstruction.

Acute intestinal obstruction usually takes up enough fluid and gas to pass through the intestines. The degree of formation of the obvious liquid level after the intestinal dilatation must reach the diagnostic level, and the colonic obstruction develops to the X-ray sign for a longer period of time. The inflated small intestine, especially the jejunum, can be identified from the annular ankle that traverses the intestine, and Distinguished from the colon with a colonic pocket shadow. In addition, the typical small intestine type is mostly in the central part of the abdomen, and the colon shadow is around the abdomen or in the pelvic cavity. According to the physical condition of the patient, the patient can take a vertical or horizontal position from the ortho position or the lateral position, and if necessary, perform a series of radiography.

Differential diagnosis

First, we should analyze the presence or absence of mechanical obstruction factors from the medical history. Dynamic intestinal obstruction includes common paralytic and rare intestinal obstruction;

Mechanical intestinal obstruction is characterized by paroxysmal intestinal colic hyperthyroidism and asymmetric abdominal distension;

The paralytic ileus is characterized by the disappearance of the colic with no colic and the uniform expansion of the abdomen;

Sputum intestinal obstruction can have sudden onset of severe abdominal pain and disappearance. Intermittent irregular bowel sounds are weakened without disappearing but no abdominal distension X-ray abdominal plain film helps identify:

Intestinal flatulence of mechanical obstruction is limited to the intestine above the obstruction site;

In the case of paralytic obstruction, the stomach and small intestine and colon have the same degree of flatulence;

In the case of spastic obstruction, there is no obvious flatulence and dilatation in the intestine. The positive lateral abdominal plain film is taken every minute to observe the movement of the small intestine to identify mechanical and paralytic ileus.

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