Tenderness in the side abdominal wall or lower back

Introduction When the infection of the retroperitoneal space is obvious in patients with colorectal injury, there is tenderness in the lateral abdominal wall or the back of the lower back, and sometimes subcutaneous emphysema can be reached. Nausea and vomiting are also common symptoms. The diagnosis and treatment of colon damage is relatively complicated. The colon wall is thin, the blood supply is poor, and the healing is not good; a large amount of bacteria and feces accumulate in the colon, which is prone to infection; the peristalsis and contraction of the colon are strong, the pressure in the intestinal lumen is large, and the contents of the intestine easily leak through the injury site or the anastomosis. Abdominal cavity; ascending colon and descending colon are peritoneal meta-organs, relatively fixed, no peritoneum behind, when the extraperitoneal part of the colon injury can cause severe widespread infection of the retroperitoneum, and difficult to early diagnosis.

Cause

Colonic injury is a hollow organ injury. After the colon rupture, the intestinal contents overflow and stimulate the peritoneum to cause peritonitis. This is consistent with the clinical manifestations of other hollow organ ruptures, but the colon contents are less irritating to the peritoneum, so the clinical diagnosis of colon injury Symptoms and signs develop slowly, often without timely diagnosis and treatment, and it is worthy of caution. The clinical manifestations of colon injury depend mainly on the extent of the injury, the location, the time of the visit after the injury, and whether there are other organ injuries at the same time.

an examination

Related inspection

CT examination full physical examination

Penetrating colonic injury is mainly characterized by abdominal pain after injury, with peritonitis, or faecal intestinal contents from the open wound. Non-penetrating colon injury, clinical manifestations are complex, abdominal pain is a common symptom, a small number of patients with colon injury may have no abdominal pain symptoms when injured, more common in the left half of the colon injury, due to the left colon content dry, ruptured hindgut The contents are not easy to enter the abdominal cavity, and the peritoneal stimulation is small. In patients with delayed colon rupture, the symptoms of abdominal pain once again improved and then reappeared.

Those who have combined with other organ damage will have shock in the early stage. In the early stage of extraperitoneal colon injury, abdominal pain and peritonitis were not obvious. When the infection of the retroperitoneal space is obvious, there is tenderness in the lateral abdominal wall or the back of the lower back, and sometimes subcutaneous emphysema can be reached. Nausea and vomiting are also common symptoms. Low colon injury can be blood in the stool or jam-like stool. Elevated body temperature is a late manifestation of peritonitis.

Colonic damage caused by colonoscopy is during the examination, the patient suddenly has severe abdominal pain, followed by peritonitis. In addition to the severe abdominal pain caused by barium enema, the patient's general condition is poor, and the expectorant enters the abdominal cavity under fluoroscopy.

Differential diagnosis

Abdominal pain refers to the manifestations of intra-abdominal and external organs caused by various reasons. It is pain in the abdomen. Abdominal pain can be divided into acute and chronic causes, including inflammatory tumor hemorrhage, obstruction, perforation trauma and Dysfunction, etc. There are many causes of abdominal pain. Almost every disease can be caused by intra-abdominal organ disease or extra-abdominal disease. It can be organic or functional. It can be a medical condition or a surgical disease. Even the initial medical problems, followed by the development of the disease and surgical conditions.

Low back pain is a disease with the main symptom of pain on one side or both sides of the waist. Western medicine for kidney disease, rheumatism, lumbar muscle strain, spinal and spinal cord diseases and other low back pain, can refer to the syndrome differentiation and treatment. Women's ropes are tightly bundled with pain, and gradually relieved after menstruation. The authors of the periodicity are called "lacing back pain."

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