Sigmoid colon wall thickening_Sigmoid colon wall thickening

Many people like to eat pig intestines. No matter whether they are large or small, as long as they are handled cleanly and the chef has good skills, they will taste good. In fact, we humans also have intestines. The ones we hear about most often are definitely the duodenum, or appendicitis. Thickening of the sigmoid colon wall is also a common symptom in the intestine due to an unhealthy diet. So how should sigmoid colon wall thickening be treated?

The best way is to do an ultrasound endoscopy and colonoscopy to further clarify the situation and provide symptomatic treatment.

The rectum is the last section of the digestive tract, located in the pelvic cavity, about 15 to 20 cm long. Its course is not a straight line but has several bends. It has three transverse folds, two on the left and one on the right, with different heights. When viewed from below, the three folds overlap each other, surrounding the rectum and supporting feces.

The section of the rectum near the anus expands into the rectal ampulla, which contains 6 to 10 vertical folds called anal columns, and above the anal columns there is a venous plexus. The rectum ends at the anus. The anus has an external anal sphincter and an internal anal sphincter. The external anal sphincter is a voluntary muscle and belongs to the perineal muscles. The internal anal sphincter is formed by the thickening of the intestinal circular muscle and is a smooth muscle. Its function is to completely remove waste remaining in the anal canal at the end of defecation.

Diseases related to the rectum and their clinical treatment :

1. Urethral rectal fistula: The male fistula is located in the membranous urethra and is most commonly complicated by high anal atresia. Therefore, when treating anal atresia, urethral stenosis or even urethral cut-off may occur. When some ligation fistulas are too far away from the urethra, diverticulum-like cavities may be left behind, which may lead to secondary infection or stones due to urine retention. In the case of urethral rectal fistula, some children may have lower urinary tract infection. If there is no concurrent upper urinary tract malformation and vesicoureteral reflux, the harm is not serious. Urine discharge from the anus and feces discharge from the urethra are the main symptoms of urethrorectal fistula. Digital rectal examination can feel the depressed fistula opening on the anterior wall of the rectum about 2 cm away from the anus. Treatment is through sacrococcygeal incision, transrectal resection and closure of the fistula and temporary urinary diversion, such as cystostomy.

2.Appendicorectal fistula:

【Case】

The patient is an 8-year-old male of Han nationality, a student from Sichuan Province, and lives in Wuquanshan, Chengguan District, Lanzhou City. He was admitted to the hospital on February 13, 1998.

One year before admission, the patient was hospitalized for abdominal pain and fever, which was relieved after infusion. Later, he had repeated fever, abdominal pain, diarrhea, and bloody stools. He was treated in many hospitals and was still given infusion, antibiotics, and symptomatic treatment, but the diagnosis was unclear. He had been to many hospitals in Shenzhen, Guangzhou, Shanghai, Beijing, etc. but to no avail. The disease recurred before this admission, so he came to the pediatric surgery department for treatment, requesting that the cause of the disease be identified so that he could have a more ideal treatment.

Physical examination: T37.4℃, P98 times/min, R22 times/min, BP90/70mmHg, well-developed, poorly nourished, pale complexion, mild anemia, flat abdomen, tenderness in the lower abdomen and right lower abdomen, rebound tenderness (±), no local abdominal muscle tension, no palpable masses, other abdominal examinations were normal. A digital rectal examination was performed, and the right anterior wall of the rectum was felt to be hard and tender with a depression 8 cm away from the anal verge. When the finger was pulled out, blood was found on the fingertip.

Laboratory examination: HB9.6g%, WBC10100/mm3, N74%, stool and urine tests were normal, liver and kidney function tests and serum ions were normal.

X-ray: No abnormalities were found in the abdominal plain film.

Diagnosis: appendicorectal fistula.

3. Anorectal fistula:

Anorectal fistula, also known as anal fistula, is a fistula that occurs between the anus and the lower rectum. One end of the fistula is connected to the anus or rectum, and the other end is connected to the outside of the anal skin or other parts. The fistula opening in the skin is called the external opening, and the fistula opening in the rectum is called the internal opening. This disease is more common. Although the disease has nothing to do with age, it mostly occurs in middle-aged people between 30 and 40 years old.

[Cause] Anal fistula is often caused by abscesses around the anorectum that rupture on their own, or after surgery, when the pus is discharged, the abscess cavity shrinks but does not close, forming a fistula.

[Symptoms]

(1) There are three symptoms of anal fistula: pus discharge, pain and itching.

Pus discharge is the primary symptom of anal fistula. Underwear is often damp and contaminated with pus. The amount of pus varies depending on the length of the fistula. The new fistula contains a lot of pus, which is thick and yellow with a foul odor. Chronic fistulas have less pus, which is sometimes present and sometimes absent. The pus is white and thin like water. If the pus suddenly increases, it means a new fistula has formed. Sometimes the fistula near the anus can be temporarily closed and pus will stop flowing out, but soon the local swelling and pain will appear again, and the closed fistula will rupture again, and pus will flow out again. During examination, a depression, a nipple-like protrusion, or a granulation tissue bulge may be seen on the skin near the anus. When pressed, a small amount of pus or bloody purulent secretions will overflow.

(2) Anal fistula is generally painless. If pain occurs, it indicates inflammation.

(3) Itching is caused by pus or secretions irritating the skin around the anus, and is often accompanied by eczema.

[Treatment method] The only treatment for anal fistula is surgical treatment, which includes removing or incising the anal fistula, or placing a thread in the anus.

[Home Care] Anal fistula should be treated surgically. After the operation, you should pay attention to rest, keep your bowels open, and use potassium permanganate warm water sitting bath to clean the anus every day to maintain anal hygiene. The dressing on the incision should be changed promptly to prevent infection.

[Doctor's warning] Anal fistula should be removed as soon as possible and conservative treatment should not be used to avoid the spread of the disease.

[When to go to the hospital] If you find that you have an anal fistula, you should go to the hospital as soon as possible for surgery.

[Prevention methods] Pay attention to the hygiene of the anus and vulva, and promptly treat inflammatory lesions around the anus to prevent this disease.