Necrosis of the fatty suspension of the sigmoid colon and adipose tissue
The term "fatty necrosis" means focal necrosis of adipose tissue due to various factors. Necrosis of adipose tissue occurs in the pancreas, in the retroperitoneal adipose tissue, among the fat of the omentum, mesentery, in the adipose tissue of the mediastinum, the adipose tissue of the epicardium, the adipose layer under the parietal pleura, in the subcutaneous adipose tissue and in the bone marrow.
The anatomical structure of the suspensions in the sigmoid colon suggests volvulus and the development of inflammation and necrosis. The cause of volvulus of the suspension may be soldering them with the parietal peritoneum or other organs. Many examinations of elderly people suffering from constipation have led to the conclusion that their sigmoid colon is enlarged and therefore fatty suspensions are pressed against the anterior abdominal wall.
The muscles of the anterior abdominal wall due to hypotrophic changes have hernias in the most vulnerable places, fatty suspensions of the free edge of the sigmoid colon fall into the depression or fossa of the parietal peritoneum, become inflamed and soldered to it. Subsequently, necrosis may develop.
There are several types of fatty necrosis
· Enzymatic fat necrosis is a consequence of acute pancreatitis and damage to the pancreas, formed when pancreatic enzymes exit from the ducts into the surrounding tissues. Pancreatic lipase breaks down triglycerides in fat cells into glycerol and fatty acids, which in turn interact with plasma calcium ions to form calcium soap. White, dense plaques and nodules appear in the fatty tissue. If lipase enters the bloodstream, fat necrosis can be detected in many areas of the body.
· Non-enzymatic fat necrosis is diagnosed in the mammary gland, subcutaneous adipose tissue and in the abdominal cavity, it is called traumatic fat necrosis. It causes an increase in the number of macrophages with foamy cytoplasm, neutrophils and lymphocytes. The process of formation of connective tissue (fibrosis) can occur, it is often mistaken for the process of tumor formation.
It is known that fatty necrosis does not transform into a malignant tumor, but can simulate it. Fatty necrosis of the mammary gland occurs as a result of trauma, as a result of which small vessels are damaged, blood supply is lost. This pathology can occur during radiation therapy, with rapid weight loss.
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The disease can be painless or painful on palpation. It is characterized by enlarged lymph nodes and the formation of dimples in the skin. Treatment consists in removing the focus of fat necrosis by sectoral resection.
Inflammatory disease or necrosis of subcutaneous adipose tissue occurs mainly in newborns.
To date, the reasons have not been clarified. The main localization of the pathology is observed on the buttocks, thighs, back, upper arms and on the face. The formation of this process is preceded by a dense swelling of the skin. Necrosis in this case can be focal or widespread. It is determined by the presence of painful nodes of skin color or reddish with a purple tint and irregular shape.
In the areas of lesions, arbitrary neutralization of pathological phenomena can occur, from which no traces remain. If calcium salts are formed in the affected area by necrosis, then the liquid contents come out, and then small scars may form. In rare cases, the following symptoms are possible: a decrease in blood pressure, exhaustion, vomiting, and fever.
Analyzes indicate an increase in the concentration of calcium in the blood plasma and an abnormally elevated level of lipids. Fat necrosis in children develops as a result of birth trauma, asphyxia, exposure to low temperatures or a decrease in internal body temperature. In the study, histological changes are very important, expressed by thickening of fibrous septa, deposition of crystals inside fat cells and granulomatous cell infiltrates.
The disease is spontaneous, so treatment is not required, it is not advisable to aspirate with a needle from fluctuating skin elements, this can cause infection, and then unforeseen complications are possible. There is also disseminated adipose tissue necrosis, when adipose tissue around the joints is necrotic.
At the same time, the body temperature always rises, arthritis develops, and the joints are destroyed. Disseminated necrosis of adipose tissue also occurs from the fact that enzymes of the pancreas enter the blood or lymph. The death rate in this type of fat necrosis is very high, you should always remember that you should inform your doctor about any symptoms of unwell. Only timely medical assistance helps to maintain health.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
