Symptoms and complications of intestinal amebsa
Intestinal amoebiasis is a slowly progressive disease occurring in 2/3 of cases, in 1/3 of cases it proceeds at a more rapid pace.
Symptoms of intestinal amebiasisFor the first case the characteristic oligosymptomatic initial period, which takes place almost imperceptibly. Observed loose stools with a frequency of five times a day, sometimes a admixture of mucus, sometimes blood. Pain in the abdominal cavity occur after several days and are expressed not sharply.
For the rapidly progressive course characterized by the simultaneous occurrence of abdominal pain and diarrhea. Mucus and blood appears on the 1-3 day of disease. Pain are colicky, and during a bowel movement increase. Body temperature is subfebrile.
Approximately 42 % of the patients during endoscopy (sigmoidoscopy or fibrocolonoscopy) found changes of the sigmoid and rectum that is caused by inflammatory processes. The changes are dynamic in nature. On the second or third day of the disease should note the areas of hyperemia, the diameter of which is 2–5 mm on the background of normal mucosa. These areas rise relative to the level of unchanging divisions of the intestines. On the fourth or fifth day slight ulcers and nodules on the location sites of hyperemia. With pressure on them is released cheesy mass with yellowish tint. Surrounds the ulcer area of hyperemia of the small size. On 6 to 14-th day of the disease is the detection of ulcers, which have a diameter of up to 20 mm have saped edges and filled with necrotic masses. It follows that changes of the mucous membrane, are characteristic of amoebiasis, are formed in the first 2 weeks of the disease. For rapidly progressive forms of these changes is characterized in the sixth-eighth day of the disease.
A complication of intestinal amebiasis
To replace acute period comes a rather long-term remission, and then sickness again and becomes chronic. In the absence of antiparasitic treatment the chronic form can last more than 10 years. There are two forms: continuous and recurrent. In the latter case, of exacerbation alternating with periods of remission, characterized by only slight dyspeptic symptoms, for example mild form of bloating, abdominal pain and rumbling in the abdomen. Duringexacerbation patients do not notice much deterioration of health, and the body temperature rises. In this period isolated the pain in the right abdomen, irregularity and pain in the ileocecal region, which is similar to appendicitis.
For a continuous course of illness characteristic of the absence of remission, but the disease is with all the manifestations, which include abdominal pain, diarrhea alternating with constipation, the stool with bleeding, intermittent fever. During the long course of chronic form may develop asthenic syndrome, hypochromic anemia, a loss of appetite, and for advanced cases and a characteristic cachexia.
During sigmoidoscopy in chronic intestinal amoebiasis ulcers identified in various stages of development against the backdrop of malaisienne or unchanged mucosa. Ulcers have irregular or round in shape and diameter to 10 mm almost always deep and with saped edges. Cover the bottom of the ulcers are presented in the form of a dirty-yellow plaque after its removal the bleeding is observed. Environment of ulcers is halo erythematous mucosa. Patients who are exhausted on the background of lack of vitamins disease stands very severe, almost always a snapshot of the development and course, first and foremost, necrotic amoebic pancolitis. Also characterized by necrosis of the mucous membrane of almost all parts of the colon, and the expansion of confluent ulceration occurs almost until serous cover. This is followed by the formation of many extensive perforations of the colon. The disease occurs with severe General intoxication, and fever related to the hectic type, weakness, cold sweat and chills. We can highlight some of the hemodynamic disorders, which include small and private pulse, hypotension and disturbances of consciousness, presented in the form of drowsiness and stupor. There is an increase in diarrhea and increase in the proportion of blood and pus in the secretions, during microscopy can be easily detected nekrotizirovannye areas of the mucosa, pathogenic microbial flora and vegetative forms of amoebas.
Towards a progressive phenomena of ranjita should include hemorrhage, ulcerative lesions and swelling of the mucous membrane of the rectum, and it may cause relaxation and involuntary expiration of the fluids of the intestine.
Characteristic pathology is the rapid development of abdominal syndrome: pain around the abdomen, pronounced flatulence, symptoms related to contracture and protect the muscles of the abdominal wall, the cessation of the stupidity of the liver, signs of irritation of the abdominal cavity
During x-ray examination revealed a picture of toxic megacoloncharacterized by pneumatization terminal part of the small intestine, the free gas under the diaphragm at the time of perforation, the picture of high intestinal obstruction. Patients suffering from this disease has severe hypokalemia (1.5 mol/l) with dehydration. The lethal outcome among such patients is 80-90 %.
An important feature of amoebiasis – the development of complications, which should include limited and General peritonitis due to perforation of the intestine ameboma, loss of the mucous membrane of the rectum and bleeding of the intestines. Ameboma is tumor infiltration in the intestinal wall, which when you attach a secondary infection is prone to zagnoenie.