Stomach aches
Probably everyone has encountered it
Sometimes drink some hot water
Sometimes the last "big"
Sometimes lie down and take a break
Probably that's alleviated
Also because it is common
So a lot of people don't take it seriously
Recent
Department of Gastrointestinal Surgery, Zhijiang Branch of the First Affiliated Hospital of Zhejiang University School of Medicine
Several patients were treated with repeated abdominal pain
Look closely at the results
It was a big problem...
The 52-year-old brother has had abdominal pain for 20 years
52-year-old Brother Liu is a Taizhou native, slim, handsome, look much younger than his peers, when he was young, hard work brought up a pair of children, and now the child has a family, he also "retired from success", raising flowers at home, with small grandchildren, life is very comfortable.
To say that he was not satisfied was the repeated abdominal pain that entangled him for nearly 20 years. "I can't remember the specifics, probably in my early 30s, there was a cold, stomach pain, when I went to the hospital to see the common cold, but after getting better, I fell behind the 'root of the disease' of stomach pain." Brother Liu said.
Over the years, his "root of the disease" has to attack several times a year, when the attack feels a burst of stomach pain, and for several days can not solve the "big", the appetite has become very poor, came to the local hospital for examination, did a series of examinations, including gastrointestinal endoscopy, did not find serious problems, was diagnosed as "intestinal obstruction", after fasting, medication, etc., each time can get better.
After a long time, Brother Liu did not pay attention to his heart, and also "groped" out a set of his own solutions: eat as much as possible until seven or eight points full, do not eat particularly greasy and difficult to digest food, every time when the abdominal pain is good rest, drink some porridge or hungry a few meals, really can't stand to go to the hospital to prescribe some medicine. It's been 20 years.
In November 2021, Liu Ge's intestinal obstruction attacked again, this time not only more painful than before, but also changed from constipation to "black stool", pulling several times in a row. Brother Liu was frightened, rushed to the large hospital in Taizhou City for examination, after a series of abdominal CT, capsule endoscopy, Brother Liu was found to have bleeding in the small intestine, the local hospital considered that it may be a small intestinal ulcer, and suggested that it should be further examination in the higher hospital. Brother Liu drove to the Zhijiang Branch of the First Affiliated Hospital of Zhejiang University School of Medicine.
It turned out to be a "double-gut man"
According to Liu Ge's examination report and condition performance, Director Liu Xiaosun considered that the cause of Liu Brother's repeated intestinal obstruction for 20 years was in the small intestine, but if it was only an ulcer, it was unlikely to last for so many years, so he was admitted to hospital for further examination as soon as possible.
In order to investigate the cause, a team of gastrointestinal surgery experts arranged a small colonoscopy for him. "What we usually call colonoscopy examines the large intestine and cannot detect the small intestine." Brother Liu's doctor in charge, Zhu Kankai, said.
The expert team of chief physician Li Aiqing of the Department of Gastroenterology conducted a small colonoscopy on Brother Liu, because the total length of the small intestine is about 4-6 meters, it is necessary to observe very patiently and professionally, and it is possible to find problems. Under the golden eyes of gastroenterologists, the culprit of Liu Ge's repeated intestinal obstruction in the past 20 years has finally been caught - repeated intestinal malformations.
The small intestine is the main place for food digestion and absorption in the human body, the upper end is connected to the pylorus and the stomach, and the lower end is connected to the large intestine through the diaphragm, which is divided into three parts: duodenum, jejunum and ileum. At the end of Liu Ge's ileum, there is actually a section of "double intestine" about 30 centimeters long. To use an analogy, it is equivalent to a lane that is originally divided into two forks of the road and then merged into one lane. When the food passes through the fork in the road, it is easy to block, which leads to Liu Ge's repeated intestinal obstruction over the years, where inflammation occurs continuously from obstruction, and constantly stimulates the intestinal mucosa, causing him to bleed in the digestive tract this time and pull out black stool.
"Repetitive bowel is a rare congenital malformation, the pathogenesis is unknown, the highest incidence of the ileum, clinical manifestations vary greatly, some people may have no symptoms, some people will have intestinal obstruction, ulcers, bleeding, perforation and other complications." Chief Physician Liu Xiaosun said, "At present, the only way to solve repeated intestinal malformations in the clinic is surgery. ”
Under the leadership of Chief Physician Yu Jiren, director of gastrointestinal surgery, the gastrointestinal surgery expert team discussed Liu Ge's condition, although repeated bowel resection surgery is not complicated, but considering that Liu Ge has repeated intestinal obstruction for 20 years, it is equivalent to inflammation in the abdominal cavity, which will cause more serious abdominal adhesions, and the possibility of more serious conditions is not ruled out.
A "cocoon" has formed in the stomach
After perfecting various preoperative examinations, Chief Physician Liu Xiaosun and Attending Physician Zhu Kankai performed repeated bowel resection and intestinal reconstruction surgery for Brother Liu. However, as soon as Brother Liu's abdominal cavity was opened, it verified the previous speculation of the expert team - Brother Liu also suffered from abdominal cocoon disease - the small intestine had actually been wrapped in a thin layer of gray-white fiber film, like a huge "cocoon", and the adhesion between the intestines was serious, almost like a wet dough stuck to a ball.
In the face of such a tricky situation, in the isolation of the small intestine may accidentally cause intestinal mucosa rupture and bleeding, the surgical expert team with rich experience and excellent technology skillfully pumped "silk" peeling "cocoon", carefully and cautiously performed a difficult complex intestinal adhesion release and small intestinal arrangement for Brother Liu, just like the wet dough layer by layer, successfully completed the separation of the small intestine, and removed Brother Liu's repetitive intestine, intestinal reconstruction.
"Cocoonia is a rare abdominal disease with a preoperative diagnosis rate of only 4.6%, unless the patient's condition is already very serious, and there may be clues in imaging. The disease is usually caused by congenital malformations, malignant tumors, trauma, surgery, peritonitis history, peritoneal dialysis, viral infections, certain drug effects and other factors, so that the intra-abdominal fibrin exudation increases, forming a fibrous envelope in the small intestine, so that the intestinal ducts occur adhesions and clusters, forming abdominal masses, because the appearance of the masses is like a cocoon, so it is figuratively named abdominal cocoon disease. Chief Physician Liu Xiaosun said. Since its name in 1978, only about 100 cases have been reported worldwide in the more than 40 years.
Since Brother Liu had not done abdominal surgery before, and also ruled out the possibility of trauma and malignant tumors, the expert team considered that it was precisely because of Brother Liu's "double intestine" that he had repeated intestinal obstruction for 20 years, causing abdominal inflammation, and eventually leading to abdominal cocoon disease. Although abdominal cocoon disease is not fatal, it is like putting a "tight curse" on the small intestine, which will further aggravate the small intestine peristalsis disorder, impaired digestion and absorption function, and patients will continue to have abdominal pain, bloating, vomiting and constipation, which will seriously affect the quality of life.
At present, Brother Liu has recovered well after surgery and has been successfully discharged from the hospital, and he will continue to follow up regularly.
Repeated abdominal pain should not be underestimated, and it is necessary to seek medical screening in time
Stomach pain, constipation, may be a problem we often encounter, people eat grains, there may always be a little bit of discomfort, however, if it is repeated long-term abdominal pain and constipation, you need to go to the hospital in time for medical screening, especially when the gastroscopy has not found a problem, you must be vigilant that there is a problem with the small intestine.
Recently, the Zhijiang Branch of the First Hospital of Zhejiang University has received a number of patients who have been diagnosed with long-term repeated intestinal obstruction attacks but have not paid attention to them, and the final delay in their condition has intensified.
In addition to the above-mentioned Brother Liu, there is a 32-year-old Fuyang man, severe abdominal pain, intestinal obstruction attack, was diagnosed with inflammatory bowel disease when he was treated in the outer hospital, but the treatment was unsuccessful, came to the Zhijiang Branch of the First Hospital of Zhejiang University, after repeated research and analysis of the patient's imaging results by the team of gastroenterology and gastrointestinal surgery experts, and combined with its specific diseases, it was finally found that a long strip of diverticulum grew on his small intestine, and food entered this diverticulum, causing rupture and bleeding, resulting in abdominal pain;
There is also a 67-year-old Uncle Jiaxing, repeated intestinal obstruction attacks for more than 20 years, this time it is really painful to come to the Zhijiang Branch of the First Hospital of Zhejiang University, after the expert team's fire eyes, it was finally found that there was a hole in the mesentery of the small intestine, because there was no intervention for a long time, the surrounding small intestine actually "drilled into the hole", aggravating the condition.
Experts introduced that there are indeed difficulties in the diagnosis of small bowel diseases, ordinary imaging, gastrointestinal endoscopy are difficult to find the crux of the problem, the current Zhejiang University First Hospital carried out small colonoscopy, small intestine CTE and other examinations, can be more accurate to find problems, gastrointestinal surgery expert team in the diagnosis and treatment of various types of small intestine diseases are also experienced.
Experts from the First Hospital of Zhejiang University remind that if there is repeated abdominal pain, bloating, vomiting, constipation and other discomforts, especially repeated attacks that are difficult to diagnose and difficult to cure, we must be vigilant and go to the hospital for diagnosis and treatment in time to avoid delaying the condition.