Fleecy tumor of a thick gut
Fleecy tumor of a thick gut – the good-quality new growth coming from a ferruterous epithelium of a mucous membrane. It is more often localized in a rectum. Over time quite often is exposed to malignant regeneration. It is shown by a large number of mucous allocations from a rectum. Sometimes allocations are painted by blood. The feeling of weight, locks and feeling of a foreign matter is possible. At a low arrangement the tumor can drop out during defecation. The diagnosis is exposed on the basis of clinical symptomatology, data of a manual research of a rectum and results of additional researches. Treatment is quick.
Fleecy tumor of a thick gut
Fleecy tumor of a thick gut (fleecy polyp, fleecy adenoma, villezny adenoma, polipoidny adenoma, papillary adenoma, adenopapilloma) – the benign tumor coming from an epithelium of a mucous membrane. Makes about 5% of total of polyps of a large intestine, usually arises at advanced age. Most often settles down in a rectum, the second place on prevalence is taken by fleecy tumors of a sigmovidny gut. Women suffer less often than men. The risk of a malignization according to various data fluctuates from 60 to 90%.
The fleecy tumor of a thick gut usually represents compact knot with the wide basis, however also the creeping forms without formation of obvious tumoral knot almost tsirkulyarno covering an intestines wall can come to light. The surface of a tumor is vulnerable to mechanical influences, a large number of blood vessels therefore the new growth often bleeds has Strom, and existence of bleedings in itself is not an ozlokachestvleniye sign. Treatment is performed by experts in the field of oncology and a proktologiya.
Etiology and pathogenesis of a fleecy tumor of a thick gut
The reasons of development of fleecy tumors are not established yet. Researchers point to growth of quantity of benign tumors of a large intestine within the last decades, connecting this phenomenon with the worsening ecological situation and decrease in level of physical activity of the population. One more important factor which is negatively influencing a mucous membrane and increasing probability of development of fleecy tumors of a thick gut is change of character of food.
In a diet of the modern person high-calorific products with the high content of fats and small amount of cellulose prevail. It causes decrease in peristaltic activity of intestines. Fatty acids in the course of splitting turn into cancerogenic substances. Because of slow advance of intestinal contents time of contact of carcinogens with a mucous membrane increases, the conditions promoting development of tumoral processes are created.
Pathological anatomy of a fleecy tumor of a thick gut
The fleecy tumor represents the spongy pinkish-red education on the wide basis or a thick leg which is accurately delimited from not changed surrounding fabrics. The surface of education is covered with the thin fringed fibers consisting of the fibers of connecting fabric covered with a layer of epitelialny cages. Strom to a fleecy tumor of a thick gut it is presented by the connecting fabric penetrated by a large number of thin-walled blood vessels. The average size of a new growth – 1,5-5 cm, in some cases a polyp can reach 8-10 cm. Less often the creeping form of a fleecy tumor of a large intestine at which the new growth does not act in an intestines gleam comes to light, and plainly extends on a gut surface. In literature cases of creeping tumors more than 60 cm long are described.
Distinguish three types of fleecy tumors: without proliferation signs, with signs of proliferation and with malignization signs. Epitelialny cells of a tumor without signs of proliferation have a clear boundary, light cytoplasm and intensively painted kernels. At new growths with signs of proliferation of a cage are located more closely, borders are washed away, the kernels extended. At a malignization the morphological structure of cages is obviously changed, cages polymorphic, sites of an epithelium get into the subject fabrics.
Symptoms of a fleecy tumor of a thick gut
The disease long time can proceed asymptomatically. The main manifestation are the plentiful viscous vitreous mucous allocations reminding egg white. The amount of slime at tumors of the big size in some cases reaches 3 liters a day. Congestions of allocations in a rectum provoke desires to defecation, the patient can be emptied by one slime several times a day. Maceration and an itch in the field of an anus are possible. At a travmatization of a surface of a fleecy tumor of a thick gut kalovy masses mucous allocations are painted by blood. At frequent bleedings anemia develops.
Patients show complaints to locks and feeling of discomfort in a rectum. At the large tumors creating an obstacle to the movement of fecal masses there can be a pain syndrome. Low located tumors sometimes drop out during defecation, and patients should set them fingers. Considerable losses of protein and electrolytes at huge new growths can become the reason of a disproteinemiya and violations of water-salt balance. Partial or full intestinal impassability owing to an invagination is in some cases possible.
Diagnosis of a fleecy tumor of a thick gut
The diagnosis is established by the proctologist on the basis of the anamnesis, clinical manifestations and these objective researches. Low located fleecy tumor of a thick gut can be found in the course of the ordinary manual research. At a high arrangement of a new growth the rektoromanoskopiya or a kolonoskopiya is required. Malignant regeneration is demonstrated by deformation of a gleam of intestines, loss of mobility of bends of a gut, the raised bleeding, existence of sores, fibrous and necrotic masses on a polyp surface.
At inaccessibility of endoscopic methods of a research of patients with suspicion of a fleecy tumor of a thick gut direct to an irrigoskopiya, however, this technique can yield false-negative results because of treatment of a tumor baric weight. In doubtful cases the irrigoskopiya is repeated in 1,5-2 months. The final diagnosis is exposed by results of a histologic research of the sample taken in time of an endoscopic research, or microscopy of the come-off sites of a tumor found at a research a calla.
The differential diagnosis of a fleecy tumor of a thick gut is carried out from proktokolita and other types of polyps. At an allocation proktokolita serous and mucous, in slime pus impurity can be found. The constant pain syndrome, the periods of deteriorations short-term is characteristic, are divided by light intervals. At other kinds of polyps plentiful vitreous allocations are absent. Differences in an endoscopic, histologic and microscopic picture of a disease come to light.
Treatment and the forecast at a fleecy tumor of a thick gut
Treatment is quick, it is performed in a planned order in the conditions of a hospital. Small polyps of a rectum delete endorektalno with use of a loop, electroknife or electrothermic coagulation. At large new growths carry out a rektotomiya or a kolotomiya. In certain cases (at huge tumors, lack of full confidence in high quality of a new growth) it is necessary to resort to a resection of the site of a large intestine.
The forecast at fleecy tumors of a thick gut favorable. After surgical intervention usually there comes the absolute recovery, a recurrence is in some cases possible. Patients are placed under dispensary observation. Within the first year after operation endoscopic researches carry out quarterly, in the subsequent – annually. In the absence of treatment there is a high probability of malignant regeneration within several years after emergence of a tumor.