Angiodisplaziya of a thick gut is the disease which is followed by expansion and deformation of vessels, krovosnabzhayushchy distalny department of intestines. The main symptom of a disease are periodic bloody allocations from a rectum which at the long course of pathology can lead to development of anemia. For diagnostics the general blood test, the analysis a calla on the hidden blood, a kolonoskopiya, an angiography of mezenterialny vessels, an irrigoskopiya and a radio nuclide stsintigrafiya of a large intestine is used. Low-invasive surgical methods of treatment are most effective, conservative techniques are at a development stage.
Angiodisplaziya of a thick gut
Angiodisplaziya of a thick gut is a degenerate disease which cornerstone resistant dilatation of blood vessels with their deformation and thinning is. The disease comes to light mainly at elderly people aged 60 years are more senior. Angiodisplaziya equally often occurs at men and women. This pathology is the reason of 4% of all cases of bleedings from a large intestine. The disease in most cases does not lead to a lethal outcome, but considerably worsens quality of life of patients. Proctologists Experts in the sphere of a modern proktologiya are engaged in diagnostics and treatment of pathology develops innovative methods of treatment of a disease which could interfere effectively with bleedings from a large intestine.
Reasons and risk factors
Today the exact reasons of an angiodisplaziya of a thick gut are up to the end not clear. Constant spasms of a large intestine at which there is an expansion of blood vessels can cause a dysplasia. Often digestive tract diseases, cardiovascular diseases, pathology of kidneys and lungs, problems with blood vessels of intestines and Villebrand's disease are the reason of this pathology. Irrespective of the reason, the acquired angiodisplaziya represents a disease at which the pathological structure of normally created blood vessels of intestines is observed. Scientists also call a similar state vascular ektaziya or teleangiektaziya.
According to most of researchers, under the influence of various reasons there occurs periodic obstruction of veins of a submucous layer which is a consequence of a spasm of smooth muscles. All this leads to dilatation of veins and capillary network eventually. On this background the acquired angiodisplaziya of a thick gut is formed. This pathological state can be followed by ischemia which aggravates the course of a disease. In some cases the angiodisplaziya of a thick gut can be congenital. This pathology represents existence in intestines of vascular education – a vascular malformation. The congenital option of an angiodisplaziya is considered more rare pathology.
The main manifestation of an angiodisplaziya of a thick gut are bleedings. Against the background of it anemia often develops. The majority of bleedings are not zhizneugrozhayushchy. Only at 15% of patients massive losses of blood which can become the reason of a lethal outcome are observed. The acquired angiodisplaziya of a thick gut develops most often at persons 60 years are more senior. The main complaint of patients are bleedings from back pass. These symptoms arise against the background of physical activity or appear without the concrete reason. Often patients with this pathology are exposed to surgeries concerning intestinal bleedings. Patients from an angiodisplaziy thick gut address proctologists, surgeons and gastroenterologists, however after operation accurately it is not possible to establish the reason of bleedings.
The congenital angiodisplaziya thick guts begins to be shown in the early childhood or right after the birth. The clinical picture is in that case also presented by intestinal bleedings. Quite often bloody allocations appear after each act of defecation. An important symptom of this disease is absolute painlessness of bleedings and their accurate connection with allocation of kalovy masses. Besides, at a congenital angiodisplaziya of a thick gut the tendency to increase of volume of bleedings is observed eventually. The disease demonstration period, frequency and expressiveness of clinical manifestations depend on extent of damage of a large intestine.
Diagnostics and difdiagnostika
Diagnostic actions are appointed during consultation of the proctologist. For diagnosis of a disease endoscopy and other tool techniques is used. The main method the kolonoskopiya with a biopsy which allows to study a state mucous a large intestine is considered. At an angiodisplaziya of a thick gut local changes which are characteristic of a hemorrhagic teleangiektaziya, a syndrome of CREST and Shereshevsky-Turner's syndrome can be observed. Distinctive feature of an angiodisplaziya is that at this pathology other clinical manifestations characteristic of these syndromes are not observed.
Kolonoskopiya has high resolution thanks to which it is possible to diagnose accurately distribution of pathological process on a large intestine. At an angiodisplaziya of congenital genesis vascular protrusions on a mucous membrane which have an appearance of uneven eminences of a various form endoscopic come to light. These vascular elements are, as a rule, filled with blood. The following important method of diagnosis of a disease is the angiography at which study a condition of vessels of a large intestine. This technique provides introduction of X-ray contrast substance to a venous blood-groove. The stsintigrafiya of a thick gut is considered more narrowly targeted diagnostic procedure. It will be out by introduction of marked erythrocytes. Restriction of this technique is that bleeding at an angiodisplaziya usually has no constant character.
Contrast radiological research - the irrigoskopiya with introduction of barium allows not only to diagnose an angiodisplaziya of a thick gut, but also to specify its prevalence on departments of intestines. Besides, this technique allows to define a condition of surrounding fabrics, width and functionality of a gut. Also for diagnosis of this disease laboratory researches are used. Performing the general blood test in which it is possible to find symptoms of anemia owing to blood loss is obligatory. It is recommended to carry out the analysis a calla on the hidden blood which allows to define availability of blood in excrements.
Treatment of an angiodisplaziya of a thick gut
The main method of treatment of a disease are the endoscopic obliterating operations. However their carrying out does not exclude probability of repeated bleedings. If the patient for any reason cannot carry out surgical treatment, the embolization of vessels by means of introduction of special polymers or gel foam is shown it. Therapeutic tactics at an angiodisplaziya of a thick gut depends on the volume of blood loss, frequency of developing of bleedings and other factors. Recently drug treatment which eliminates bleedings owing to a dysplasia in intestines vessels is even more often used. According to a number of researches, good results are yielded by hormonal medicines and thalidomide. However, according to other experts, these means were insufficiently effective.
Perspective methods of treatment consider impact on a mezenterialny blood-groove and blockade of vazorasshiryayushchy peptides recently. The most widespread therapeutic methods of treatment consider use of medicines of estrogen and progesterone. At the small seldom arising intestinal bleedings methods of photocoagulation, an endoscopic ablyation and skleroziruyushchy therapy can be used. If the patient often has profuzny bleedings which sharply worsen a clinical state and lead to an anemization, then removal of the bleeding site of intestines is shown it. The sigmoidektomiya is most often made, carrying out a resection of a rectum is possible. After similar interventions reconstructive operations on sigmovidny and a rectum are carried out.
Forecast and prevention
Prevention of an angiodisplaziya of a thick gut consists in timely treatment of diseases of digestive tract and other chronic pathology capable to provoke development of this disease. The forecast for life in most cases favorable though proctologists not always manage to achieve full treatment of patients.