Pneumatosis - a pathological condition of the digestive system (most often involved gut or stomach wall), wherein the cavity (cysts) are formed in the thicker wall filled with air or gases.
As the progression of pneumatosis it can move to the area of the mesentery, lymph nodes or peritoneum.
Pneumatosis often in young children after intestinal infections that detected in operations for ileus.
Causes
Basis intestinal pneumatosis - a pathological accumulation of gases, which are usually formed in the gut, in his mucous membranes. Gases are accumulated to form air cavities and cysts, rather than absorbed into the bloodstream and output.
The main reasons for the formation of pneumatosis include:
- an early age to their low mobility,
- violation of the peristaltic movements of the intestine,
- increased intra-abdominal pressure, cramping, ulcers,
- signs of intestinal obstruction,
- violation of exhaust gases through the anus,
- severe intestinal infection with lesions of the small and large intestine, as a result of which the gas as a product vital functions of microbes, accumulated in the damaged intestinal walls (Escherichia coli, Proteus).
An additional factor in the development of intestinal pneumatosis point of air into the stomach with its penetration into the intestinal wall. Some importance is also a violation of lymphatic capillaries in the intestinal wall.
Kinds
intestinal pneumatosis may be limited or widespread in the small intestine or the entire intestine.
Most often pneumatosis iliac portion of the intestine and the ileocecal area. In this case, the intestines may resemble in appearance grapes or soap scum, in rare cases, cysts arise air alone.
Manifestations of intestinal pneumatosis
Typical and typical for pneumatosis no complaints there, all complaints are due to the processes that occur in the abdominal rug.
Cystic pneumatosis pneumatosis intestinal or simply - a rare disease and it has accumulated a few observations to accurately describe the clinical picture of the disease.
The severity and extent of intestinal and extraintestinal manifestations depend on the extent and progression of the process.
First of all, the main complaints in the intestinal pneumatosis are manifestations flatulence, In the intestine formed an excessive amount of gas, which greatly stretch the bowel wall, causing severe discomfort in the abdomen, bloating, pressure, and pain.
Passage of peristaltic waves colon may be accompanied by cramping or colicky painCan often be marked problems with a chair, while it may be the phenomenon of diarrhea (diarrhea, Liquid stool) or constipation, Lasting up to several days.
Severe bowel pneumatosis may lead to phenomena of intestinal obstruction due to closure of the lumen of the intestine distended air brush. Often, the gas pressure within the gut increases too much, resulting in the rupture of gas cysts penetration bowel contents and gases in the abdominal cavity with symptoms peritonitis.
Also featured pneumatosis can be heaviness in the stomach, belching air, gut feeling overflow air, carminative, abdominal pain during the bowel, pain relief after stool, nausea and even vomiting.
With the development of peritonitis condition abruptly disturbed, there pallor, abdominal pain and "dumb abdomen" no signs of peristalsis, reduced pressure shock.
Diagnostics
diagnostic base - is the patient's presenting complaints that are so non-specific that can occur almost any disease gut of both infectious and non-infectious origin.
These inspection may show signs of bloating and rumbling in the abdomen, a feeling of rolling gases under arms in the gut.
An experienced surgeon during palpation of the intestinal wall can detect air cysts in the gut wall, if their size is sufficiently large. Cysts are arranged in groups, chains, like bunches of grapes.
Confirm the diagnosis can only endoscopy - with them visually seen gas bubbles along the intestine.
It may also be used with the methods of radiological diagnosis or without contrast.
pneumatosis treatment
Pneumatosis usually considered as secondary process, so basically the therapy of those diseases and conditions which have caused loss of the intestinal wall.
First of all, it is the treatment of intestinal infections in infants with intestinal antiseptics and antibiotics as a result of rational planting.
With the development of intestinal obstruction needed emergency surgery, constipation - normalization of food and laxatives, while spastic colon processes - receiving antispasmodics.
When pneumatosis is also shown receiving symptomatic treatment:
- antigas preparations (anti-gas)
- antispasmodic drugs (baralgin no-spa)
- antidiarrheal drugs (Reglan, motilium)
- drugs laxative series.
When the manifestation of symptoms of peritonitis require immediate surgery and abdominal drainage.
Complications and prognosis
The main and most dangerous complication of pneumatosis could be intestinal obstruction with necrosis of the intestine and peritonitis development.
Weather favorable for life by the timely start of treatment.
