Pseudo-polyposes of an obodochny gut – a secondary pathological state at which on a mucous membrane of an obodochny gut the multiple protrusions on appearance reminding polyps are formed. Arises at inflammatory diseases of intestines and some infections of a GIT. The clinical picture a pseudo-polypose of an obodochny gut is defined by the main disease, at patients diarrhea, belly-aches, tenezma, a meteorizm, weight loss and pathological impurity in Calais can be observed. The diagnosis is exposed on the basis of data of an endoscopic research and a biopsy. KT and a X-ray analysis with contrasting are in certain cases used. Treatment of the main pathology is required.
Pseudo-polyposes of an obodochny gut
Pseudo-polyposes of an obodochny gut – a state at which on a wall of an obodochny gut there are outgrowths which imitate intestines polyps, but are sites of the remained mucous membrane or the islands of excess regeneration of a ferruterous epithelium which arose against the background of inflammatory or infectious process in an obodochny gut. Most often the development reason the pseudo-polypose of an obodochny gut becomes nonspecific ulcer colitis. According to various data, pseudo-polyps come to light at 22-64% of the patients having this disease.
Sometimes pseudo-polyposes of an obodochny gut it is found at a disease Krone and dysentery. The disease usually develops at the age of 40-65 years. Researchers note that pseudo-polyps are not inclined to an ozlokachestvleniye, at the same time in some cases in the course of regeneration of a ferruterous epithelium of a sigmovidny gut there can be sites of a dysplasia, in the subsequent transformed to a colorectal cancer. Treatment is performed by experts in the sphere of a proktologiya.
Reasons pseudo-polypose of an obodochny gut
Pseudo-polyps represent the plaques of various size and a form acting over a wall surface in an intestines gleam. Damages of a mucous sigmovidny gut at inflammatory diseases of intestines (nonspecific ulcer colitis, a disease Krone) and some infectious damages of a GIT (most often at dysentery) become the reason of formation of such plaques. At a disease the Krone of pseudo-polyposes of an obodochny gut comes to light much less than at nonspecific ulcer colitis that is caused by distinctions during and primary localization of inflammatory process at these two diseases.
Knots at a pseudo-polypose of an obodochny gut can represent the remained sites of a normal mucous membrane surrounded with ulcers and the centers of a superficial necrosis. Such outgrowths can be also formed as a result of growth of a ferruterous epithelium at restoration of mucous. Under growths islands of connecting fabric sometimes are found. In certain cases pseudo-polyposes of an obodochny gut results from formation of excess granulations. In formation of knots can play a role not only ulcerations mucous, but also intestines wall stretchings at the peristaltic movements, the trauma inflamed mucous by firm kalovy masses etc.
The quantity and the sizes of pseudo-polyps at a pseudo-polypose of an obodochny gut significantly vary. At one patients single knots, at others – the multiple educations covering a considerable part of a mucous membrane of a sigmovidny gut come to light. Average diameter of knot at a pseudo-polypose of an obodochny gut makes 5-10 millimeters, at the same time separate pseudo-polyps can reach 5 and more centimeters. Taking into account appearance of knots distinguish usual pseudo-polyps, educations in the form of a hat and deep cystous colitis.
Symptoms pseudo-polypose of an obodochny gut
The specific symptomatology is absent. Patients show the complaints characteristic of the main disease. At nonspecific ulcer colitis ponosa are observed. The kashitseobrazny chair with impurity of slime, blood and pus is possible. Patients psevdopolipozy an obodochny gut are disturbed by frequent false desires and pains in the left half of a stomach. Weakness, violations of appetite and loss of weight are noted. Expressiveness of a hyperthermia depends on weight of pathology, body temperature can fluctuate from 37 to 39 degrees. Sometimes extra intestinal symptoms come to light: joint pains, ankiloziruyushchiya spondilit (Bekhterev's disease), aftozny stomatitis, uveit, a knotty eritema and so forth.
For a pseudo-polypose of an obodochny gut at a disease Krone belly-aches, frustration of a chair, appetite loss, decrease in body weight, weakness and a hyperthermia of various degree of expressiveness are also characteristic. The same extra intestinal manifestations are found, as at nonspecific ulcer colitis. Distinctive features a pseudo-polypose of an obodochny gut at a disease Krone are tendency to formation of cicatricial narrowings of a gleam of intestines, higher frequency of development of complications (intestinal impassability, intestinal bleeding, perforation of a thick gut) and violation from a liver and kidneys. At dysenteric to a pseudo-polypose of an obodochny gut the sharp beginning, the general symptoms of intoxication and the expressed intestinal frustration are observed (a repeated diarrhea, rumbling, skhvatkoobrazny pains, pathological impurity in Calais).
Diagnostics pseudo-polypose of an obodochny gut
The diagnosis is established on the basis of endoscopic researches. In the course of a rektoromanoskopiya or a kolonoskopiya the doctor studies a condition of mucous, reveals ulcerations and other changes characteristic of the nonspecific ulcer colitis and other diseases capable to provoke pseudo-polyposes of an obodochny gut. The endoscopist estimates quantity, the size and a form of pseudo-polyps, takes samples of fabric of knots and the neighboring sites of a mucous membrane for a morphological research.
In the course of studying of morphological structure of the educations arising at patients psevdopolipozy an obodochny gut not changed epithelium, growths of an epithelium or granulyatsionny fabric is defined. At a research of the mucous membrane affected with ulcer colitis expanded capillaries, hemorrhages, ulcers and crypts abscesses come to light. The submucous layer is usually changed slightly. The mucous membrane of intestines at patients with a disease Krone rough, hilly, on appearance reminds "cobblestone road".
Irrigoskopiya at a pseudo-polypose of an obodochny gut of a maloinformativn as allows to find only rather large pseudo-polyps and at the same time does not give the chance to estimate a form of knots, a state and a general view of a mucous membrane. The computer tomography provides more exact results, but, as well as the contrast X-ray analysis, does not provide to the doctor enough information for a differentiation a pseudo-polypose of an obodochny gut and other diseases which are followed by emergence of defects of filling on roentgenograms. Both techniques apply only at inaccessibility of endoscopic researches or existence of contraindications to carrying out a rektoromanoskopiya and kolonoskopiya.
Differential diagnostics a pseudo-polypose of an obodochny gut is performed with multiple polyps, a diffusion family polipoz, a colorectal cancer, lipomas and kartsinoida of an obodochny gut. The final diagnosis is exposed on the basis of data of a microscopic research.
Treatment pseudo-polypose of an obodochny gut
Tactics of treatment is defined depending on a look and severity of the main pathology. At nonspecific ulcer colitis recommend the good balanced nutrition, during the periods of an aggravation appoint immunosupressor, glucocorticoid means and medicines of 5-aminosalicylic acid. At a pseudo-polypose of an obodochny gut with the expressed violations of water and electrolytic exchange carry out infusional therapy. According to indications apply antibiotics. At inefficiency of conservative therapy, a dysplasia of a mucous membrane, pronounced extra intestinal displays and complications of nonspecific ulcer colitis (megacolon, perforation of a sigmovidny gut, intestinal bleeding, an ozlokachestvleniye of the site of the changed mucous membrane) carry out surgical interventions.
Therapy a pseudo-polypose of an obodochny gut at a disease Krone also provides use of glucocorticoids, immunosupressor, medicines of 5-aminosalicylic acid and antibiotics. In addition appoint tumor necrosis factor blockers, blockers of integrinovy receptors, vitamin D and hyperbaric oxygenation. At complications perform operations. Nonspecific ulcer colitis and a disease Krone are chronic diseases with a recidivous current. Regular surveys and the supporting therapy during remission are necessary for patients.
At a pseudo-polypose of an obodochny gut, caused by dysentery and other intestinal infections, appoint a special diet, carry out etiotropny therapy with use of antimicrobic medicines, carry out dezintoksikatsionny actions. The forecast at this pathology is defined by type and features of a course of the main disease. Patients with psevdopolipozy an obodochny gut are under observation of the proctologist and gastroenterologist.