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Colitis
 Definición
Inflammatory and ulcerosa, chronic and inespecífica disease,
that is originated in the mucosa of the colon and it is characterized,
most of the times by a diarrea sanguinolienta.
The term "colitis" must be applied only to the inflammatory
disease of the colon (for example, ulcerosa, granulomatosa, isquémica
or by radiation; disentería to basilar or amebiana). The colitis "is
pástica" or "mucous". It is an erroneous denomination
applied often to a functional upheaval that is described more suitably
with the term (internal null and voidable).
The ulcerosa colitis can affect clients of any age, but the curve
of ages of beginning shows to a bimodal distribution with a main maximum
the 15 and 30 years and a second maximum minor to the 50 and 70 years,
that can include some cases of isquémica colitis.
Pathological anatomy
The disease begins in general, the rectosisgmoidea area and can extend
in proximal direction, affecting with time all the colon, or imply all
the heavy intestine simultaneously. The ulcerosa proctitis, a very frequent
and more benign, although often refractory form of the disease, usually
stays located in the rectum, although also it can undergo a later proximal
dissemination in around 10% of the cases.
The anatomopatológica alteration begins with a degeneration
of fibers of reticulina located below epitelio mucous, with occlusion
of the subepithelial and progressive infiltration of the own lamina
by plasmáticas cells, eosinófilos capillaries, lymphocytes,
mastiocitos and leukocytes polimorfonucleares. Finally, epithelial necrosis
and ulceración of the mucosa
Symptoms and signs
The habitual manifestations consist of episodes of diarreas sanguinolientas
of variable intensity and duration, interrupted by asintomáticos
intervals. The episode can be acute and sudden, with a sudden diarrea
and does violence to, high fever, signs of deep peritonitis and toxemia.
Most frequently the crisis begins of incidiosa form, with an increase
in the urgency of defecación, slight espasmos in inferior half
of the abdomen and appearance of blood and snot in lees.
When the ulceroso process is limited the rectosigmoidea area, the
depositions can be normal or hard and dry, but there is a rectal snot
secretion with hematies and leukocytes that accompany the depositions
or it takes place among them. The sistémicos symptoms are slight
or nonexistent. If the process extends in proximal direction, the depositions
tend to be softer and the client can have of 10 to 20 daily intestinal
movements, often with intense pains that persist during the night. The
depositions can be watery and to contain pus, blood and snot; frequently
blood and puses consist solely of. It can have malaise and fever, anemia,
anorexy, loss of weight, leucositosis, hipoalvuminemia and increase
of the VSG when there is an extensive colitis.
Complications
The hemorrhage is the more frequent local complication. In the toxic
colitis, particularly serious local complication, the transmural extension
of the ulceroso process produces a located tleo and peritonitis. As
the toxic colitis progresses, the colon loses its muscular tone and,
in a term of days and even hours, it begins to dilate.
The simple x-rays of abdomen show intraluminal gas accumulation in
a segment of long, continuous and paralyzed, consecutive colon to the
loss of the muscular tone. When the diameter of the colon transcerso
surpasses the 6 cm., it says that there is megacolon toxic (or toxic
expansion). |
