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EdrawMindChapter 27 Ulcerative colitis✓
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Chapter 27 Ulcerative colitis✓
Internal Medicine Chapter 3 Digestive System Diseases Ulcerative colitis UC, the lesions are mostly in the sigmoid colon and rectum, are continuously distributed, are limited to the mucosa and submucosa, and are complicated by perforation, acne ducts, and pericolonic abscesses are rare. The mucosal surface becomes congested, edematous, infiltrated by inflammatory cells, and shallow ulcers appear. In the late stage, a large number of granulations proliferate, and inflammatory polyps appear.
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Chapter 27 Ulcerative colitis✓
- bacteria
This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
- Plant asexual reproduction
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
- Reproductive development of animals
This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
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- Outline
ulcerative colitis UC
Cause
immune factors
genetic factors
Infectious factors
Psychological factors
pathology
Most of the lesions are in the sigmoid colon and rectum, with continuous distribution, limited to the mucosa and submucosa, and Perforations, acne ducts, and pericolonic abscesses are rare. The mucosal surface becomes congested, edematous, infiltrated by inflammatory cells, and shallow ulcers appear. In the late stage, a large number of granulations proliferate, and inflammatory polyps appear.
clinical manifestations
Digestive system performance
symptom
Diarrhea and bloody stools with mucus, pus, and pus
stomach ache
Loss of appetite, anorexia, bloating, nausea and vomiting
physical signs
Mild and moderate patients only have mild tenderness in the left lower abdomen (colon), and sometimes the tubular sigmoid colon can be palpated. Moderate patients have obvious abdominal tenderness.
If signs such as abdominal muscle tension, rebound tenderness, and weakened bowel sounds occur, you should be alert to the occurrence of complications such as toxic megacolon and intestinal perforation.
Patients with megacolon may have tympani in the liver area. Tenderness during digital rectal examination or blood on the finger cuff indicates proctitis
Systemic manifestations
Fever may occur during the active stage, and high fever often occurs in severe cases; patients with persistently active or severe disease are often accompanied by symptoms such as weakness, weight loss, anemia, hypoalbuminemia, dehydration, and electrolyte imbalance; hypokalemia is particularly likely to occur.
extraintestinal manifestations
It can be accompanied by a variety of extraintestinal manifestations, such as arthritis, erythema nodosum, iritis, sacroiliitis, ankylosing spondylitis, pyoderma gangrenosum, recurrent oral ulcers, etc.
complication
toxic megacolon
cancer
Massive intestinal bleeding (the most dangerous, mostly related to toxic megacolon), intestinal perforation, intestinal obstruction, fistula and perianal abscess, etc.
Auxiliary inspection
colonoscopy
stool test
Immunological examination
blood test
Diagnose based on
①Chronic persistent diarrhea, mucus, pus and bloody stools, abdominal pain, systemic symptoms of varying degrees, with a tendency to recur
②No pathogen found in multiple fecal examinations
③Colonoscopy and X-ray barium enema examination show colitis lesions
Differential diagnosis
chronic bacillary dysentery
Amoebic dysentery
colorectal cancer
Schistosomiasis
Crohn's disease CD
irritable bowel syndrome
treat
General treatment
daily life
supportive care
antibiotic treatment
psychological counseling
medical treatement
Aminosalicylic acid preparations
Glucocorticoids
immunosuppressant
Thalidomide
biologics
Probiotics
Surgical treatment
Massive bleeding, perforation, cancer and highly suspected cancer are absolute indications for surgical treatment
Indications for elective surgery
①Complicated colon cancer
② For cases in the chronic active phase, medical treatment results are unsatisfactory and seriously affect the quality of life, or although the condition can be controlled with glucocorticoids, the side effects are too great and cannot be tolerated. Total colectomy and ileostomy are generally used