Acute blockage of intestinal mesenteric vessels: causes, symptoms, treatment. Mesentery of the large intestine and its relationship with neighboring organs Common mesentery of the small and large intestine

Acute blockage of intestinal mesenteric vessels (in the language of medical terminology - acute occlusion of mesenteric vessels) is an acute violation of blood flow in the mesenteric vessels, which leads to a deterioration in the nutrition of the intestinal wall and the development of various pathological processes in it. The mesentery is a thin film of connective tissue that anchors the intestines to the abdominal wall and carries its blood vessels and nerves. Therefore, occlusion of the mesenteric vessels is fraught with severe disorders of the small and large intestine along its entire length.

common data

Acute obstruction of the mesenteric vessels is considered a gastroenterological emergency.... But in fact, they are engaged in it in a surgical hospital, since a circulatory disorder of the intestine leads to its irreversible changes that require surgical intervention.

The degree of intestinal damage in acute occlusion of the mesenteric vessels depends on factors such as:

• type of blockage;
• the level in the blood vessel where it occurred;
• the presence of additional arterial pathways that can take over the function of a blood supplier in case of blockage of other branches and compensate for the lack of blood supply (they are called collateral blood flow paths).

Blockage of the mesenteric vessels can be:

• arterial;
• venous;
• mixed (arteriovenous).

In 90% of all clinical cases of occlusion of mesenteric vessels, blockage of the main trunk of one of the largest mesenteric arteries - the superior mesenteric arteries - or its large branches occurs. This artery plays a major role in the blood supply to the gastrointestinal tract. The inferior mesenteric artery can also be blocked, but it has well developed the mentioned collateral branches, so its blockage at any of the levels is not so fraught.

The mesenteric veins are less likely to clog. Also, cases of mixed blockage of the mesenteric (mesenteric) arteries and veins are not very common. With a mixed type of occlusion, first there is a chronic blockage of one vessel, and already against its background - an acute blockage of another.

note

Most often, this pathology is observed in men. It is mainly diagnosed over the age of 50.

Causes

Acute blockage of intestinal mesenteric vessels can be caused by:

• thrombus - a thickened blood clot;
• embolus - any biological substrate that is in the lumen of the vessel, is not associated with it and can easily migrate with the blood flow.

In most clinical cases, the mesenteric vessels are clogged with a thrombus.

Pathology rarely occurs due to the formation of a blood clot directly in the mesenteric vessels. In the bulk, it is preceded by diseases of the cardiovascular system, as a result of which thrombi are formed, which then migrate to the mesenteric vessels, although there may be non-vascular causes of occlusion of the mesenteric arteries and veins. Most often this happens with diseases and conditions such as:

The following can act as an embolus:

Disease development

Having entered the mesenteric vessel with blood flow, a thrombus or embolus blocks its lumen.

Often, the formation of a blood clot, which will subsequently lead to a blockage of the vessel, is preceded by the so-called Vikhrov triad:

• changes in the walls of the vessel;
• increased blood clotting;
• local (local) slowing down of blood flow.

In some cases, even a small thrombus or embolus that freely migrated in the vascular system with the blood flow can clog the vessel at any time, expanding in it.

Acute blockage of the mesenteric vessels of the intestine is manifested by a sharp disturbance of blood flow. It develops in the vascular areas above and below the blocked area. In response to irritation of the inner lining of the vessel, into which the edges of the thrombus or embolus have "rested", the vessel reacts with a spasm, which further aggravates the obstruction to blood in this part of the vascular system. Another aggravating factor is additional thrombus formation at the site of the blockage. As a result of all these pathological processes, the flow of oxygen and nutrients to the intestinal tissues stops, an acute violation of its nutrition and ischemia (oxygen starvation) of the intestinal wall develops.

If no measures are taken to resume blood flow, or if a thrombus (embolus) does not spontaneously slip out of the vessel's bottleneck, destructive (destructive) changes in the intestinal tissues develop very soon, which are provided by blood thanks to this vessel. Such changes are irreversible.

The most severe consequences of acute blockage of the mesenteric vessels are anemic (due to a violation of blood flow) and hemorrhagic (due to minor hemorrhages) necrosis of the intestinal wall. Therefore, occlusion of mesenteric vessels is characterized by an extremely severe course and a high mortality rate.

Acute obstruction of the intestinal mesenteric vessels can occur in three forms - with compensation, subcompensation and decompensation of mesenteric blood flow. The difference between them is as follows:

• at compensation the intestinal wall suffers from short-term starvation, but then anatomically and functionally restored completely. This can happen spontaneously or with conservative therapy;
• at subcompensation stealing of mesenteric blood flow is observed, intestinal tissues are partially supplied with blood and do not receive nutrients, which leads to the development of a number of intestinal diseases, but often non-critical and treatable. With subcompensation of mesenteric blood flow, abdominal toad may occur (oxygen starvation of the intestine, leading to a deterioration of its functions), (inflammatory lesion of the small intestine), (inflammation of the mucous membrane of the large intestine), including peptic ulcer, and some other diseases;
• with decompensation, the mesenteric blood flow practically stops, which leads to necrosis of the intestinal wall, the addition of infection, the development of diffuse purulent and the emergence of a severe septic condition with a threat of death.

Symptoms

Acute obstruction of the mesenteric vessels may not appear immediately - it may be preceded by the so-called precursors of the disease (a similar principle is with the manifestation of precursors during a pre-infarction state, if the blood flow in the vessels of the heart is disturbed). It depends on the degree of blood supply disorder. These precursor symptoms are called abdominal toad and are:

• seizures
• persistent;
• pretty fast weight loss.

Characteristics of pain in abdominal toad:

Such signs should cause medical alertness, since there is a risk of acute occlusion of the intestinal mesenteric vessels.

But in most cases, the blockage of the vessels of the mesentery begins suddenly, without precursors. Its clinical manifestations depend on the stage of the disease. There are three successively developing stages of occlusion of the intestinal mesenteric vessels:

• ischemia;
• heart attack;

The stage of ischemia develops in the first 6-12 hours after the blockage. Its clinical manifestations are as follows:

• unbearable abdominal pain in the form of severe contractions . The patient cannot sit still, tries to alleviate his condition and for this takes a forced posture - twists into a "ball" and brings his legs to the stomach;
• severe nausea with vomiting almost immediately. First, bile and blood streaks (hereinafter referred to as blood clots) can be found in the vomit. With the progression of the disease, vomit has a fecal odor;
• frequent loose stools in which they are found. Such a chair is also called ischemic (due to oxygen starvation) bowel emptying.

The stage of a heart attack develops in the interval of 12-18 hours from the moment of blockage. Its clinical manifestations are as follows:

• pain felt at rest, to some extent, subside, but pain increases when feeling the abdomen;
• the general condition of the patient worsens;
• manifestations of diarrhea are reduced, the stool is partially normalized.

The stage of peritonitis occurs 18-36 hours after the blockage. Its clinical manifestations are as follows:

Diagnostics

Symptoms in acute obstruction of the mesenteric vessels are quite pronounced, observation of changes in complaints is especially helpful in diagnostics. Also, such details of the anamnesis (history of the disease) as the acute onset of abdominal pain and the patient's cardiovascular diseases are important. To confirm the diagnosis, use physical (examination, palpation, percussion, abdominal auscultation), instrumental and laboratory diagnostic methods.

In the stage of ischemia, the physical examination data will be as follows:

Changes in the cardiovascular system are observed:

• an increase in blood pressure by an average of 60-80 units (the so-called Blinov symptom);
• the pulse becomes more rare than normal.

In the stage of a heart attack, the physical examination data will be as follows:

• upon examination, a further deterioration in the general condition of the patient is noted;
• on palpation in the place where the affected intestine is projected, pain increases. You can also grope for an elongated cylindrical swollen formation with a doughy consistency;
• with percussion, there is pain in the affected area;
• during auscultation, no special changes were noted.

• blood pressure returns to normal levels;
• the pulse begins to quicken.

In the stage of peritonitis, the physical examination data will be as follows:

• on examination, the patient's serious condition is recorded. The skin is pale, earthy, the tongue is extremely dry, coated with a white-dirty coating, the stomach does not take part in the act of breathing;
• on palpation - severe pain, the anterior abdominal wall is tense (surgeons characterize it: "like a board"), the symptoms of peritoneal irritation are clearly defined;
• with percussion - severe pain even with a slight tapping on the anterior abdominal wall;
• on auscultation - peristaltic noises are absent due to the onset of paralytic intestinal obstruction.

Changes in the cardiovascular system are as follows:

• severe arterial hypotension;
• marked increase in heart rate.

To clarify the localization of the lesion and other details, such instrumental diagnostic methods are used as:

Of the laboratory methods of examination in the diagnosis of occlusion of mesenteric vessels, the most informative are:

• - the addition of infection and necrosis of the intestinal wall will be indicated by a significant increase in the number of leukocytes and ESR. Also, the risk of thrombus formation is assessed by the number of platelets;
• - determine the amount of cholesterol in the blood, thereby obtaining an indirect opportunity to determine the state of the inner surface of the vessels;
• - after analyzing its indicators, the properties of the blood coagulation system and the ability to thrombus are evaluated.

Differential diagnosis

Symptoms characteristic of acute occlusion of mesenteric vessels can be observed in other diseases, with which it is necessary to carry out a differential diagnosis of obstruction of the mesenteric vessels. These are pathologies such as:

• perforated and duodenal ulcer;
• sharp;
• (dynamic and mechanical);
• sharp;
• acute (calculous and non-calculous).

Treatment

With signs of acute inclusion of mesenteric vessels of the intestine, the patient is urgently hospitalized in the surgical department.

At the heart of the treatment of such a pathology:

• conservative therapy;
• surgical intervention.

The operation must be performed urgently. The purpose of the surgery is as follows:

• revision (examination and evaluation) of the mesentery to check blood flow and bowel to assess its viability;
• elimination of the cause that provoked vascular obstruction;
• restoration of blood flow through the mesenteric vessels;
• resection (removal) of dead areas of the intestine.

The resumption of blood flow (revascularization) through the mesenteric vessels is performed by such methods as:

• removal of a blood clot (thrombectomy);
• removal of an embolus (embolectomy);
• bypass grafting - creation of bypass blood flow paths using a vascular prosthesis (prosthetics of the superior mesenteric artery). Performed in especially severe cases.

If necrosis has developed in the intestinal wall, then these sections of the intestine are excised. Excision is performed with the capture of healthy intestinal tissue, because the appearance of the affected intestinal segment does not correspond to the level of deterioration of blood flow (external changes may be delayed). In some cases, surgeons decide on a second laparotomy (after 24-48 hours) in order to monitor the state of the intestine.

Conservative treatment begins at the stage of preparation of the patient for surgery, continues during and after surgery. Conservative therapy is based on such prescriptions as:

• antithrombotic drugs to prevent re-thromboembolism of the mesenteric vessels;
• intensive infusion therapy - is carried out to restore the volume of circulating blood, improve blood supply to tissues and tissue metabolism (metabolism), stabilize the work of the cardiovascular system, and remove the patient from pain shock;
• - to prevent the development of infectious complications, and if they have already developed - to stop them;
• oxygen therapy - the supply of oxygen through a mask to the respiratory tract.

Prevention

It is possible to prevent the occurrence of acute occlusion of the mesenteric vessels of the intestine if the sources of thrombus formation are eliminated in a timely manner. First of all, this means the identification and treatment of diseases such as:

Clinical vigilance is also needed in relation to vascular blockage by emboli - in the first place:

The prognosis for this disease is complex. If it is possible to restore blood flow in the mesenteric arteries during the first 4-6 hours after the onset of vascular blockage, then it is possible to avoid intestinal infarction and resume its normal activity.

As a rule, surgical treatment is carried out in the second and third stages of occlusion - mainly due to the late treatment of patients, as well as the time required for diagnostic measures. Due to late assistance, the mortality rate is 80-90%.The prognosis worsens due to the underlying pathology, which contributed to the formation of a thrombus and blockage of mesenteric vessels.

4) the mesentery of the stomach

77. The wall of the right mesenteric sinus is

1) the wall of the abdominal cavity

Ascending colon

3) the descending colon

4) the right lobe of the liver

78. The wall of the left mesenteric sinus is

1) the wall of the abdominal cavity

2) gastro-splenic ligament

The mesentery of the small intestine

4) the ascending colon

79.anatomical structure involved in the formation of the walls of the omental opening

1) square lobe of the liver

2) stomach

Duodenum

4) hepato-gastric ligament

80.the organ occupying an intraperitoneal position

Cecum

3) pancreas

81.Feature of the 1st upper molar tooth of a person

Roots can penetrate into the maxillary sinus

2) it has no root

3) there is a fabric hood between the crown and the gum

4) the crown does not completely cut through

82.Women are more likely to get cystitis than men, because

1) women have a smaller diameter of the urethra

2) the female urethra has a narrowing

Women have a shorter urethra

4) in women, the course of the urethra is straight

83.Meckel diverticulum is called

1) non-clogged venous duct

2) an open urinary duct

3) unsealed umbilical vessels

Embryonic residue of the bile duct

84.the relief of the mucous membrane of the pylorus of the stomach is presented

Longitudinal folds

2) circular folds

3) folds without a specific orientation

4) alternating circular and longitudinal folds

85.The first narrowing of the esophagus is located

At the junction of the pharynx into the esophagus

2) at the level of aortic narrowing

3) at the level of bronchial constriction

4) at the level of diaphragmatic constriction

86. The rectal-uterine cavity is

1) the space between the rectum and the uterus, filled with fatty tissue

The part of the abdomen located between the uterus and rectum

3) cellular space, limited by the sheets of the fascia of the pelvis

4) the space between the rectum and the wide ligaments of the uterus

87. The large (vater) duodenal papilla is located

1) at the top

In the descending part

3) in the horizontal part

4) in the ascending part

88. The pancreas is a gland

1) external secretion

2) internal secretion

Mixed secretion

4) in fact, it's not iron

SECTION V. "RESPIRATORY SYSTEM"

1.part of the respiratory system that is part of the upper respiratory tract

Mouth pharynx

2) larynx

2.function of the respiratory tract

Moisturizing

2) gas exchange

3) metabolic

4) phagocytic

3.anatomical formation (of the listed), which is part of the lower respiratory tract

1) the mouth of the pharynx

Larynx

3) the nasal part of the pharynx

4) laryngeal part of the pharynx

4.Glands of the vestibule of the nose

1) serous

2) mucous membranes

Sweat

4) mixed

5.the cavernous venous plexuses of the nasal cavity are located

In the area of \u200b\u200bthe inferior turbinate

2) in the area of \u200b\u200bthe middle turbinate

3) in the olfactory area

4) in the respiratory area

6.with the lower nasal passage

1) middle cells of the ethmoid bone

Nasolacrimal canal

3) maxillary sinus

4) posterior ethmoid cells

7.with the middle nasal passage

Frontal sinus

2) nasolacrimal canal

The mesentery of the intestine is the sheets of the peritoneum, with the help of which the internal organs (stomach, large, small intestine, and others) are attached to the back wall of the abdomen.

The mesentery has a branched network of blood vessels, nerve endings and lymph nodes, which are involved in supplying the organ with the necessary nutrients, transmitting nerve impulses and maintaining the immunity of internal organs.

Mesentery structure

Some organs located in the peritoneal cavity have a serous membrane. The folds of the peritoneum that surround the loops of the small and large intestines are called the mesentery. But it is worth noting that not all parts of the digestive tract have peritoneal sheets.

For example, at the level of the duodenum, they are completely absent, and the mesentery of the small intestine is most developed. The back of the mesentery, which attaches to the abdominal wall, makes up the mesentery root. Its size is small and reaches about 16 cm.

The opposite edge, which affects the entire small intestine, is equal to the length of these two sections. Further, the mesentery goes to the intestinal loops and surrounds them in such a way that they are tightly fixed between the sheets of the peritoneum.

What role does it play?

The main function of mesentery is to separate most of the organs from the posterior abdominal wall and prevent the organs from dropping into the pelvis when the body is upright. The mesenteric vessels provide the intestinal wall with sufficient oxygen, which is essential for normal functioning.

Nerve cells send impulses to the brain and receive them back. The lymph nodes at the base of the mesentery provide a protective function for the entire intestine.

Diseases

Mesenteric infarction

Mesenteric infarction and intestinal infarction occur as a result of impaired circulation of the mesenteric vessels due to thrombosis or embolism. The main clinical manifestation of pathology is severe pain in the navel. However, it should be noted that palpation of the abdomen remains soft and slightly painful.

Over time, the pain subsides, and with complete necrosis of the intestinal wall, it disappears altogether, which interferes with a positive prognosis.

The patient's skin is pale, the tongue is dry and has a white coating. It happens that after a few hours from the onset of tissue necrosis, fluid effusion into the abdominal cavity (ascites) begins.

If you do not go to the hospital on time, then the disease begins to progress and the person becomes lethargic, apathetic. Even if you start to take the necessary measures after extensive necrosis, then coma and seizures may occur. To confirm the diagnosis, specialists appoint ultrasound of the abdominal organs, X-ray irradiation, laparoscopy.

The best way is surgical intervention.

Treatment consists in removing all foci of necrosis

Mesenteric cyst

A benign thin-walled neoplasm that has no muscle layer or epithelial layer. Cysts appear between 2 sheets of the mesentery of any part of the digestive system and are not associated with the intestines. The most common cyst of the mesentery of the small intestine.

The process of the appearance and growth of neoplasms takes a long time, therefore, during this period, the patient does not notice any manifestations. To make the correct diagnosis, palpation of the abdomen is performed, in which a mobile mesenteric tumor is well felt, painless. Treatment of cysts is carried out only by surgery.

Cancer

Malignant neoplasm that leads to tissue breakdown. Pathology is much less common than cysts. The clinical picture of tumors is similar to cystic formation. The first symptoms begin to appear only when the tumor is large and compresses the internal organs.

Patients begin to complain of pain in the abdomen of varying intensity, nausea and vomiting, belching, flatulence. Diagnosing oncology is quite problematic, but with the help of ultrasound and CT, it is possible to identify the location of the tumor, its size, and consistency. Treatment of mesenteric cancer is surgical, chemotherapy and radiation.

The gap

It occurs against the background of an abdominal injury and is combined with a violation of the integrity of neighboring organs, in particular, the small or large intestine. The rupture of the mesentery occurs both with penetrating wounds and closed abdominal injuries.

The main symptom of the pathology is the development of shock in the first hours, then it weakens or is replaced by another sign - internal bleeding or the onset of peritonitis. The bleeding pattern begins with pallor of the skin and mucous membranes, the pulse weakens and gradually disappears, in the general blood test there will be a low content of hemoglobin and red blood cells.

It is very difficult to recognize a rupture by radiation and clinical methods.

The only effective way is laparoscopy. During it, treatment is performed (the hematoma is removed, the bleeding vessels are bandaged, the damaged mesentery is sutured).

Inflammation

The inflammatory process, as a separate pathology, occurs extremely rarely. Most often it occurs against the background of peritonitis, since the serous membrane is involved in this disease. It is almost impossible to recognize the inflammation of the mesentery, since the clinical picture can be varied.

The most common symptom of pathology is soreness in the navel of varying intensity. The mesenteric lymph nodes increase in size, swelling and redness of the inflamed area appear. Over time, the mesenteric tissue is replaced in places by the connective tissue, turning into dense scars. As a result, the walls of the mesentery grow together and shrink.

Treatment of any disease is aimed at eliminating the inflammatory process. Several groups of drugs are used for therapy: antibiotics, antispasmodics and pain relievers. In addition, diet is a prerequisite on the path to recovery. In the case of a purulent process, surgical intervention with complete sanitation of the abdominal cavity is indicated.

One of the types of duplications that provide fixation of organs to the walls is the mesentery. There are also other duplications, which are usually called folds, ligaments and omentaries.

One of the most important functions in the abdominal cavity is performed by the peritoneum. It prevents the spread of infectious processes, is an impenetrable barrier for toxic substances and normalizes intestinal activity and much more.

The peritoneum is a sac that hermetically envelops the internal organs (it consists of a basement membrane and mesothelium). Passing from the walls of the abdomen to the internal organs, it forms ligaments, folds, oil seals, in which blood, lymph vessels and nerve trunks pass.

The main task is to isolate the internal organs from the cavity. This explains the fact that most often purulent processes (for example, appendicular infiltration) are localized.

The peritoneum covering the walls of the abdomen is called parietal, and, passing to the organs, it is called visceral. Between these leaves there is a small amount of serous fluid, which acts as a lubricant.

Main functions:

• release and absorption of transudate;
• isolation of purulent processes;
• fixation of organs;
• immune protection.

What is duplication and its types

The peritoneum covers the anterior wall, after which it follows into the pelvic cavity, where it passes to the bottom of the bladder, to the uterus (in women) and the rectum, after which it passes to the intestinal loops.

It is important to understand that in the places where the peritoneum passes to the organs, the so-called dulicatures (doublings) are formed. They are designed to fix organs. Most often, duplicates contain adipose tissue, blood vessels and nerves.

There are such duplicates:

• mesentery;
• ligaments;
• folds;
• oil seals.

What is the mesentery?

So, the mesentery is a duplication of the sheets, which provides fixation of the intestinal loops to the back wall. This element is found in the small intestine, in some cases in the cecum and sigmoid colon, as well as fallopian tubes.

Some types of mesentery are:

1. Thin - called mesenterium - consists of 2 layers that go from the loops of the jejunum and ileum in the direction of the II lumbar vertebra, where the point of its fixation (root) is located. In order to find the beginning of the mesentery in surgery, a fairly simple technique is used - it is necessary to find the transition from the duodenum to the jejunum (Treitz's ligament). The mesenterium is directed from left to right (length about 9 cm), as a result of which two sinuses (spaces) are formed in the cavity - the right and left mesenteric sinuses. In pathological conditions, the length of the mesentery may increase. It crosses the front of the aorta and the inferior vena cava, and in its structure passes the superior mesenteric vein and artery, lymphatic vessels that feed the intestinal walls and internal nerves.
2. Blind - has a similar structure and occurs in 80% of cases. It should be noted that sometimes it extends to the appendicular process (mesoappendix). The mesentery contains branches of the superior mesenteric artery, lymphatic vessels and nerve trunks.
3. The transverse colon divides the abdominal cavity into the upper and middle floors. Its root is fixed in the region of the upper edge of the II lumbar vertebra. It goes to the posterior surface of the transverse colon, after which it continues into the greater omentum.
4. Sigmoid - fixes the distal parts of the large intestine. The length of the mesosigmoid decreases from top to bottom, so the upper and middle sections are more mobile.
5. The mesentery of the fallopian tubes (mesosalpinx) - provides fixation of the appendages to the walls of the small pelvis.

What are folds?

Also among duplicates, attention should be paid to the folds, where pus, blood, and exudate most often accumulate. They form in the places where the peritoneum covers large vessels, ligaments and ducts.

You should highlight such folds as:

• the outer, middle and median umbilical fold, in which the vessels and ligaments of the same name pass;
• upper and lower duodenal fold - in the places of transition to the duodenum;
• the ileal cecum and the cecum fold - in the places of transition to the intestinal sections of the same name.

What are peritoneal ligaments?

Another type of duplication is ligaments. In the abdominal cavity, they perform a fixation function, and are also part of many anatomical structures. They are formed during embryogenesis, when the relationship between the intestine and the peritoneum changes.

The main bundles:

• hepato-gastric - connects the gate of the liver with the lesser curvature of the stomach (Laterzhe nerves and gastric arteries pass through it);
• hepato-duodenal - located between the gates of the liver and the duodenum 12 (portal vessels and bile duct pass through it);
• gastro-colon - reports the greater curvature of the stomach and the upper colon;
• gastro-splenic - participates in the formation of the greater omentum;
• gastrophrenic - closes access to the left periocolic sinus.

At least 10 more different ligaments can be distinguished that participate in the formation of the Winslow hole and provide fixation of various organs.

The most important formations of the abdominal cavity should also include the omentum, which is a double duplication. They are also called abdominal orderlies, since they limit the organs in the form of an apron.

The large intestine belongs to the organs of the digestive tract. This section of the gastrointestinal tract has the widest lumen. In the large intestine, feces are formed, as well as the absorption of water from digested food residues. This organ is subdivided into 5 anatomical sections. One of them is the transverse colon. It represents the central department. As in other parts of the large intestine, pathological processes can develop in it. This organ is treated by a gastroenterologist and a surgeon.

Anatomical structure of the transverse colon

The transverse section of the colon is located between the descending and descending parts. It runs from the hepatic to the splenic flexure. The transverse section is located in the form of a loop. It can be located above or below the level of the umbilical ring. In some cases, the transverse colon reaches the pelvis. In length, it is considered the longest (about 50 cm).

Inside, this section is represented by a mucous membrane. The transverse intestine is lined with a cylindrical unilamellar epithelium. The mucosal lamina consists of fibrous connective tissue. It contains exocrine glands and accumulations of lymphoid cells. The submucosal layer contains blood and lymph vessels, as well as nerves. The muscular membrane is represented by smooth muscles. There are 3 sphincters along the transverse colon. The first is in the proximal region, the second is in the middle, and the third is at the splenic flexure.

The mesentery of the transverse colon is located along the back wall of the abdomen. It contains blood and lymph vessels. The transverse colon is covered by the peritoneum on all sides. Therefore, it belongs to intraperitoneal anatomical formations.

The importance of the transverse colon in the body

The transverse is the median. It performs the following functions:

1. Production of the secret necessary for the formation of final products - excrement. Exocrine glands are involved in the breakdown of fiber.
2. Moving the contents through the intestinal lumen It is carried out thanks to the presence of special ribbons - haustra, as well as sphincters.
3. Absorption of liquid from chyme, fat-soluble vitamins, glucose and amino acids.

The transverse colon is of great importance, since all these functions are essential for the digestive process. In the lumen of this section, there are many bacteria that make up the normal microflora. They are necessary to maintain acid-base balance. In addition, the normal microflora is involved in the inactivation of pathogenic bacteria.

Transverse colon: topography

The digestive organs are located above the transverse colon. Among them are the liver, gallbladder, spleen. Anteriorly, the transverse intestine is adjacent to the anterior abdominal wall. Therefore, it is easily palpable. The lower edge of the organ is adjacent to the loops of the small intestine. The pancreas, left kidney and duodenum are located behind. These anatomical structures are separated from the transverse colon by means of the mesocolon - the mesentery. It provides blood supply and outflow of lymph from this department.

An omentum is located between the transverse colon and the greater curvature of the stomach. It forms a bundle. The organ is supplied with blood by branches from the superior and inferior mesenteric arteries.

Causes of pathologies of the transverse colon

The defeat of the transverse colon can occur due to various reasons. In some cases, the disease is formed in early childhood or in the prenatal period. This is due to improper laying of fetal tissues. Other causes of pathologies include the following effects:

1. Mechanical damage to the intestinal mucosa.
2. Bacterial and viral lesions.
3. Functional impairments resulting from neurological diseases.
4. Chemical influences.
5. The appearance of neoplasms in the lumen of the transverse colon.
6. Acute and chronic disturbance of blood circulation in the mesenteric vessels.
7. Chronic destructive processes.

All these reasons lead to disruption of the functioning of the transverse colon. The result is indigestion. All pathological conditions require treatment. Indeed, in its absence, stagnation of feces and intoxication of the whole organism occurs.

Diseases of the transverse colon

If abdominal pain occurs, pay attention to whether the transverse colon is affected. Damage symptoms can vary. Clinical manifestations depend on the pathological process that has developed in the patient. The following groups of diseases of the transverse colon are distinguished:

In early childhood, congenital bowel pathologies are found. These include Hirschsprung's disease, cystic fibrosis, megacolon.

Symptoms of pathologies of the transverse colon of the intestine

Signs of diseases of the transverse colon include: pain, impaired stool consistency and defecation, symptoms of intoxication. Unpleasant sensations in the navel area or slightly below its level can be observed in any pathological condition. If the disease is caused by pathogens of intestinal infection, it will be strongly expressed. In this case, frequent loose stools are noted, which may contain various impurities - mucus, blood. In some infectious processes, feces acquire a characteristic color and smell (in the form of "swamp mud", "frog caviar", "rice water"). Dysentery is characterized by severe cramps in the left abdomen and false urge to defecate.

In chronic inflammatory processes, discomfort in the abdomen, diarrhea, alternating with stool retention are periodically noted. Damage to the intestinal wall leads to the formation of bleeding ulcers.

Vascular disorders, fecal congestion and congenital anomalies lead to the development of intestinal obstruction. This disease belongs to acute surgical conditions. Regardless of the reason that led to the obstruction, help is required immediately.

Benign intestinal neoplasms

A benign tumor of the transverse colon can arise from any tissue that makes up the organ wall. The varieties of this group of diseases include: polyp, myoma, fibroma, hemangioma. Benign neoplasms are characterized by the fact that they grow into the lumen of an organ without affecting the thickness of the wall. A common type of tumor is a polyp of the transverse colon. It is a small growth facing the organ cavity. With a small formation, the polyp may not appear in any way. However, it needs to be removed. Due to the constant passage of feces through the intestine, the benign tumor is damaged, it can bleed or become infected. There is a high risk that the polyp will "grow" into an oncological process.

Malignant tumors of the transverse colon

Transverse colon cancer affects older people but can develop in younger patients as well. Most often it occurs against the background of chronic inflammatory pathologies, polyposis. Symptoms of cancer include pain, stool disturbance, and bowel obstruction if the tumor is large. In advanced cases, patients cannot eat, there is an increase in the inguinal lymph nodes, an increase in body temperature, weight loss and weakness.

Transverse colon: treatment of pathologies

Treatment of diseases of the transverse colon can be conservative and operative. In the first case, antibacterial medicines are used (drugs "Ciprofloxacin", "Azithromycin"), anti-inflammatory drugs. Diarrhea is an indication for rehydration therapy. The liquid is introduced in various ways. If the patient's condition is satisfactory, give to drink alkaline mineral water, "Rehydron" solution. In severe cases, fluid is injected into a vein. When diarrhea is prescribed medicines "Smecta", "Hilak-forte", which contribute to the normalization of the intestines.

With destructive and oncological diseases, an operation is performed. It consists in resection of the transverse colon and stitching the free ends. After surgery, it is necessary to follow a diet, since the restoration of organ functions does not occur immediately.