Causes and symptoms of small intestine necrosis
The small intestine is part of the alimentary canal that connects the pyloric sphincter and the cecum. In this organ, food is digested, nutrients are absorbed through its walls into the blood and lymph, it takes part in immune and metabolic processes. The causes of necrosis of the small intestine can be a violation of the venous or arterial circulation, microbial infection. In the list of causes, diseases of the central nervous system are also distinguished.
A decrease in intestinal permeability implies a deterioration in the state of the intestines, a decrease in immunity, metabolic disorders and is a favorable factor for the development of necrotic processes and its spread to the tissues of other organs of the digestive tract.
In order to prevent intestinal necrosis, treatment of ischemia should be started in time, which leads to insufficient blood flow in certain areas or in all parts of the intestine. The development of acute intestinal ischemia is a consequence of a chronic disturbance of the mesenteric circulation. As a result of acute intestinal ischemia, hypoxia (oxygen starvation) occurs, after a time (from 2 to 6 hours), irreversible intestinal necrosis develops.
Types of intestinal necrosis
There are two types of necrosis. Coagulation or "dry" necrosis develops due to tissue dehydration and protein coagulation. The intestinal tissue atrophies, becomes dry, dense and separates from living tissue. This type of necrosis affects the tissues in the case of chronic arterial insufficiency, without showing any significant symptoms. The unfavorable outcome of dry necrosis is conversion to wet intestinal necrosis.
Colliquation or wet intestinal necrosis is characterized by the spread of putrefactive microorganisms in non-viable tissues, as a result of which the patient feels painful symptoms. Wet intestinal necrosis causes intestinal gangrene and therefore surgical intervention is inevitable.
Strangulated necrosis occurs when intestinal obstruction, which can be caused by a violation of the evacuation of intestinal contents, blockage of the intestinal tube from the inside by a foreign body. Obstruction is often caused by a pathological process of the intestinal wall or squeezing of the intestine from the outside, for example, by tumors formed in other organs.
With strangulated obstruction, a decrease in the lumen of the intestine and a decrease in the compression of the mesenteric vessels appear, blood circulation is impaired, necrosis of the intestinal walls and peritonitis develop. In this case, there are constant pains of a spasmodic nature.
Bowel necrosis symptoms
To identify the disease, it is necessary to collect a complete history. Particular attention is paid to the nature of feces, the frequency of bowel movements, the presence and nature of abdominal pain, the causes of bloating. When familiarizing with the patient's complaints, one can identify symptoms that occur only when the small intestine is affected by necrosis. Symptoms include general weakness and weight loss, dry skin, sudden abdominal pain, frequent urge to defecate, blood in the stool, nausea, and vomiting.
Symptoms of intestinal necrosis can be fever, increased heart rate, decreased blood pressure, dry tongue. Any alarming symptoms should be a signal to see a doctor. Necrosis or death of intestinal tissue requires urgent surgical intervention, otherwise it is impossible to prolong the life of a sick person.
In diagnosis, it is effective to use CT angiography or MR angiography - contrast is injected into the vascular bed, and then images are taken using a computer or magnetic resonance imaging scanner to see areas of vascular blockage. The Doppler apparatus helps in making an accurate diagnosis using ultrasound, which displays the speed of blood flow in the arteries.
Pathology can be identified using endoscopy or colonoscopy. A modern method in surgery called "Diagnostic operation" allows, when diagnosing and detecting a necrotic area of the small intestine, immediately, immediately remove dead tissue.
Intestinal necrosis treatment
First of all, it is necessary to restore normal blood flow and repair damage caused by oxygen starvation of cells. Anticoagulants are prescribed to prevent blood clots. The main direction in the treatment of various types of necrosis of the small intestine is to prevent the further development of putrefactive microorganisms, to intensively conduct antibacterial and detoxification therapy.
You always have a choice - live healthy or die from the irreversible consequences of necrosis. Healthy and wholesome food, a life without tobacco and alcohol, regular visits to the doctor are the key to a long and happy life.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
