| Objective:Through the lesion occurred in the cecum of cases were retrospectively analyzed,summarized species, distribution,clinical characteristics,misdiagnosed condition, imaging, pathological features and treatment effects of the cecum diseases in order to strengthen the ileocecal awareness of the disease.Materials and methods:the total of 149 hospitalized cases of ileocecal lesions occurred in were Collected in a hospital from January 2002 to August 2010, for age, sex, occupation, duration, incentives, disease location, clinical manifestations, imaging, endoscopy and pathology, hospital stay, treatment and efficacy of a list of registered projects, and applied statistical methods to reach appropriate conclusions.Result:Ileocecal carcinoma in 58 cases,24 cases of ulcerative colitis,21 cases of intestinal tuberculosis,Crohn's disease in 16 cases,6 cases of primary intestinal lymphoma,7 cases of ileocecal inflammation, eosinophilic enteritis in 3 cases,2 cases of amoebic dysentery,systemic lupus erythematosus inl cases,1 case of intestinal Behcet's disease, no confirmed cases in 10 cases.10 cases of intestinal tuberculosis confined to the ileocecal,only 1 case of ulcerative colitis, ileocecal cancer has been discovered 36 cases (64.29%) metastasis.In terms of age,Crohn's disease,intestinal tuberculosis,ulcerative colitis compared between the age of P> 0.05,can not explain age differences between the three.But three and the age of ileocecal cancer compared equal to 0.000,P<0.001.over 60 years old patients had 50 cases,of which belong to the ileocecal carcinoma in 38 cases (76.00%).This group of diseases in the clinical manifestations,abdominal pain as the most common,followed by anemia,4 patients without any clinical manifestations,found only in the physical examination.The highest incidence of intestinal tuberculosis heat (52.38%), ulcerative colitis abdominal pain and bloody stool as the main performance,account for 79.17%.Primary intestinal lymphoma with abdominal pain and abdominal pain and abdominal mass as the main performance.While 36 cases of patients with abdominal mass,of which 32 cases (88.89%) were malignant lesions.In the secondary inspection,99 cases (66.44%) underwent B-mode ultrasound in 46 cases (46.46%) had abnormal.Gastrointestinal barium meal examination in 17 cases,5 cases (29.41%) had abnormal.53 (35.57%) underwent abdominal CT examination,45 patients (84.91%) had abnormal findings;compare B-effect and gastrointestinal bariumMeal,the X2 test was P> 0.05,these two methods were compared with abdominal CT,were obtained by the X2 test P=0.000<0.05.Misdiagnosed, misdiagnosis of 34 cases (22.82%),misdiagnosis occurred in 11 cases of 128 routine colonoscopy, the X2 test was P=0.001<0.05.In the misdiagnosis the highest rate of intestinal tuberculosis misdiagnosed 47.62%, followed by Crohn's disease,31.25%.There were still 10 cases (6.71%)which had not gotten the final diagnosis.TCM diagnosis,abdominal pain 58 cases,the accumulation of 34 cases,blood in the stool,diarrhea and dysentery of all were 18 cases,Consumption in 2 cases,fox puzzled of 1 case.Spleen and Kidney deficiency proof was the most of the intestines tuberculosis (38.09%),damp-heat proof,Spleen deficiency proof were the same to Spleen and Kidney deficiency certificate in Crohn's disease,ulcerative colitis to damp-heat the main (37.50%),followed by spleen deficiency syndrome (25.00%),ileocecal cancer to blood stasis syndrome (46.55%),followed by a spleen deficiency syndrome (27.59).the total of the above four diseases was 119 cases,Most cases in which blood stasis syndrome was 33 (27.73%),followed by 31 cases of spleen deficiency syndrome (26.05%),belonging to damp-heat the 24 patients (20.17%),spleen and kidney deficiency syndrome in 19 cases (15.97%),cold cards in 6 cases (5.04%), both yin and yang deficiency syndrome 4 cases (3.36%), liver qi stagnation in 2 cases (1.68%).Conclusion:(1)Common in the ileocecal disease,ileocecal cancer which taked up the largest proportion,which was diagnosed the most of the transfer had taken placed,so that the parts of early detection of disease and timely diagnosis is urgently needed to solve the problem,especially in the elderly and patients with palpable mass in the right lower abdominal should arouse the clinician's attention.(2)ileocecal disease,relying solely on clinical manifestations and a secondary inspection is difficult to diagnose。gastrointestinal barium meal,B ultrasonic examination,which may easily lead to misdiagnosis.Abdominal CT has a high value,the early detection of disease early detection and reduce misdiagnosis.Timely colonoscopy can reduce the misdiagnosis rate.(3)Abdominal pain was the most common of TCM diagnosis,followed by accumulation.Ileocecal disease,the main syndromes:blood stasis syndrome, spleen deficiency syndrome,damp-heat syndrome,spleen and kidney deficiency syndrome. |
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