Intestinal stricture

Introduction Intestinal atresia and intestinal stenosis are common congenital gastrointestinal malformations in neonatal intestinal obstruction, which can occur in any part of the intestine. The jejunum and ileum are more common, followed by the duodenum, and the colon is rare. Occurs in the elderly. Diarrhea, abdominal pain, malabsorption, and protein-losing enteropathy are common manifestations. Common complications include intestinal perforation and gastrointestinal bleeding, and less complicated intestinal obstruction. Microscopically, small intestine villi atrophy, lymphocytes, plasma cells, histiocytes and neutrophils infiltrated at the bottom and around the ulcer.

Cause

(1) Causes of the disease

The cause is unknown, often in patients with celiac disease, and some patients also have lymphoma and intestinal adenoma. However, whether these diseases are the cause of this disease needs further clarification.

(two) pathogenesis

The ulcers of this disease are multiple, most often involving the jejunum, followed by the ileum, occasionally in the duodenum or colon. The ulcer is generally deeper and reaches the muscular layer, so it is easy to cause perforation or scarring of the serosa surface. Microscopically, small intestine villi atrophy, lymphocytes, plasma cells, histiocytes and neutrophils infiltrated at the bottom and around the ulcer. Gastric mucosal metaplasia is sometimes seen on the edge of the ulcer. The intestinal mucosa between the ulcer and the ulcer is normal or has an inflammatory change.

an examination

Related inspection

Gastrointestinal CT examination

Diagnosis is difficult. X-ray angiography or endoscopy revealed small intestine ulcers, if other diseases can be ruled out. This disease should be considered. Oral jejunal mucosal biopsy can sometimes obtain specimens with diagnostic value, but care should be taken to avoid intestinal perforation. Surgical exploration, postoperative intestinal resection specimen biopsy is a reliable basis for diagnosis.

Differential diagnosis

Bacterial dysentery

Caused by Shigella, diarrhea with pus or mucus is more common, less, and often have urgency and heavy, mostly cold and heat. A large number of pus, red blood cells and phagocytic cells can be found in stool microscopy. Infant poisoning bacillary dysentery or atypical bacillary dysentery should be identified by pathogenic diagnosis.

2. Viral diarrhea

Diarrhea caused by enterovirus infection is characterized by high infectivity. Rotavirus, small round virus and other infections have vomiting in the early stage, followed by diarrhea, mostly watery stools and mucus, mostly in autumn and winter. Other viral diarrhea is more common in summer and autumn, there are nausea and vomiting, in addition to gastrointestinal symptoms, often have respiratory symptoms, pharyngitis, and convulsions, often involving the neck muscles, back muscles. In the age of one year, children often see green watery or egg-like water. Antibiotic treatment is generally ineffective, and the course of disease is self-healing in 5 to 7 days. Further identification by serology and virus isolation.

3. Campylobacter enteritis

Campylobacter jejuni causes mild and viral enteritis, which is similar to ulcerative colitis or Crohn's disease. There is fever, diarrhea watery or mucus-like stool, there is stench, it is bile color, severe pus and bloody stools, and more bacteriophage recovers in 1 week. Children often have abdominal cramps, and convulsions can occur when there is high fever. The incidence is mostly related to exposure to poultry, livestock or drinking unsterilized milk and raw water. Dark-field microscopy can detect the archaea-like active bacterium of the archery, and the bacterial culture is further diagnosed.

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