bowel infarction - an acute circulatory disorder in the intestinal wall of a local nature, which leads to necrosis. It is more common in elderly patients, in 60% of cases in women after 70 years. Forecast to recovery unfavorable because diagnosis is difficult. In most cases, the factors influencing the emergence of diseases - heart disease.
Causes
Risk factors that can lead to the development of pathology:
- Thrombotic. Formation of thrombus occluding the artery most often, at least - mesenteric vein to cause disease, one of the signs that is increased blood clotting: an abnormal growth of bone marrow, the aggravation of pancreatitis, heart failure.
- Embolic. Appear when entering vessels in the mesentery the bloodstream adipose tissue fragments, parasites (e.g., echinococci), clots formed in the other body tissues.
- Occlusion. The disease develops in the background: atrial fibrillation, cardiac and aortic aneurysms, disorders bleeding, dehydration, sepsis, injuries of different nature and intolerance health drugs.
By thrombotic causes of necrosis of the bowel wall include tumor and organ injury, the treatment of hormonal drugs, including reception OK. It has been suggested that the mesenteric vascular occlusion causes incorrectly delivered by intravenous injection (to exposure in the air circulation). To embolism occurred under pressure, enter at least 15 cubic meters. cm of air. Accidentally it can be done.
Only by knowing in advance what the bowel infarction, and what it is possible to prevent its occurrence. Due to violations of mesenteric circulation (mesenteric vascular occlusion) is rapidly developing bowel necrosis, causing peritonitis.
symptomatology
Condition worsens gradually. With the development of the disease appear minor abdominal pain, weakness, lethargy, the temperature rises to subfebrile. Additional symptoms in the stage of compensation - increased blood pressure, impaired bowel movement and blood fragments in the faeces. Diagnosis is difficult since at first signs can detect abnormalities only through laboratory tests.
In the next step (subcompensation) symptomatology amplified. The tissue of the intestine may not receive nutrients and oxygen, pain replaced by sharp pains, increases flatulence. Overstrained muscles, may cause "acute abdomen" - it becomes hard to palpation. Nausea. Pathological changes that arise at this stage are irreversible.
Decompensation of organ function are broken, there is necrosis. If the aid is not provided for 6 hours, to save the life impossible. There is peritonitis, the infection penetrates into the abdominal cavity and begins the decay of tissues.
Clinical picture is characterized as compensation for ischemia. Pathological changes reversible, the body tries to compensate the disturbance of blood supply at a single site, increasing blood flow to the other. At this stage it is possible to make a diagnosis based on the general analysis of blood and fecal occult blood may purpose diagnostic procedures - laparoscopy or laparotomy, during which removed once formed thrombi. If the disease is detected early, the prognosis for recovery is favorable.
Treatment
Conservative methods allow to suspend the progress of the disease and its complications, prepare the patient for surgery. Fibrinolytic use - urokinase, streptokinase and the like, solutions to eliminate intoxication - electrolytes, antispasmodics to improve blood flow. To prevent infection prescribe antibiotics.
But even with the early detection of pathological process without surgery cost in rare cases. If treatment begins at the compensation stage is removed emboli or thrombi from the mesenteric vessels. During surgery or at subcompensation decompensation resection - removing part of the intestine. Excisable extensive areas, or restore blood flow in the vessels impossible.
Types of surgery:
- embolectomy - withdraw emboli;
- thrombectomy - thrombus excised together with the damaged vessel;
- resection - is carried out in necrosis, remove the intestinal loops.
To arrest the peritonitis, during handling the peritoneal cavity is washed with antiseptic agents and establish drainage.
long-term rehabilitation. When extensive excision of the bowel may be required life-long parenteral nutrition.
Specific preventive measures are developed. To reduce the risk of heart attack intestinal development is recommended to constantly monitor blood clotting, to avoid injuries of the abdomen, promptly seek medical attention if deterioration in cardiac diseases, blood vessels, and an exacerbation of chronic pancreatitis.
