From Big Medical Encyclopedia

TYPHLITIS (Greek typhlos blind + - itis) — an inflammation of a caecum, segmented colitis.

To emergence of T. the stagnation a calla in a caecum (see) favoring to development of a pathogenic indestinal flora promotes. T. can develop as a result of hematogenous spread of an infection at acute inf. diseases (typhoid, sepsis, measles, flu, etc.). Also transition of inflammatory process to a caecum from the next bodies is possible in the lymphogenous way. T. can accompany appendicitis (see). At a disease Krone (see. Krone disease ), tuberculosis of intestines (see. Intestines ), an abdominal actinomycosis (see) the ileotyphlitis develops.

Wedge, picture it is characterized by dull aches in the right ileal area. Sometimes pains have the nature of colic, develop in 5 — 6 hours after food, amplify at the movements, long standing, in a prone position on the left side, can irradiate to the lumbar area. Rumbling, a meteorism, nausea, an eructation, a loss of appetite, sometimes a diarrhea are noted feeling of a raspiraniye in a stomach (in some cases at daybreak patients wake up from a desire on defecation — a so-called diarrhea alarm clock). Alternation of a diarrhea and a lock is more often noted, however there is also a normal chair. In the period of an aggravation the stomach is blown up (sometimes only in the right ileal area), the front abdominal wall is not strained, the caecum is condensed, painful, is ballonoobrazno inflated, mobile, the tympanic sound is perkutorno defined. At an ileotyphlitis the expressed capotement is defined.

Treat complications development of insufficiency of the ileocecal valve — the bauginiyevy gate (see. Caecum ), mesadenitis (see) and a paratyphlitis — an inflammation of retroperitoneal cellulose. The perityphlitis — an inflammation of the peritoneum covering a caecum can be considered as a complication or as manifestation of a typhlitis. To distinguish clinically peri-and a paratyphlitis difficult. At a perityphlitis of pain become persistent, the gut is not displaced at a palpation.

Diagnosis put on the basis of a clinical picture, and also data of koprologichesky and radiological researches. At koprol. a research the calla, a large amount of the digested cellulose, intracellular starch, yodofilny flora, the changed muscle fibers, insignificant amount of the split fat define subacidic reaction. Rentgenol. research T. includes an irrigoskopiya (see), roentgenoscopy at antegrade filling of ileocecal area, pariyetografiya (see). Frequent rentgenol. symptom of T. change of a gleam (increase or narrowing) of a caecum is. In cases of a delay of a chyme (see) at an atony, and also at an excess of the ascending colon or at a mobile caecum its gleam is expanded, the liquid and slime which are in it create a picture of a mramornost. Narrowing of a gleam of a caecum, sometimes uneven is more often noted. At sharp narrowing the struck department takes a form of a cord. The changed caecum especially in the period of an exacerbation of a disease densely is not filled with barium. Structure of a baric column porous or cellular. Gaustra smooth out, take irregular shape, and during the progressing of process disappear. Contours of a caecum equal and accurate or small - and krupnozubchaty. Characteristic sign of T. shortening and deformation of a caecum is, edges can take the funneled or cylindrical form. A relief of a mucous membrane at T. it is changed, has a cellular appearance, folds are often maleficiated or are absent. In nek-ry cases on an inner surface of a caecum there are resistant baric spots indicating existence of ulcers and erosion. Increase in the ileocecal valve, insufficient reduction of a caecum during the emptying is often observed. At a double contrast study the border between the blind and ascending colon, narrowing of a caecum, roughness of contours, rigidity of walls, a cellular or porous structure of a pneumorelief is defined more clearly. At an aggravation of T. Shtirlin's symptom can be revealed (see. Shtirlina symptom ). Deformation, shift, a thickening of a wall of a caecum, its union with an abdominal wall and the next bodies is characteristic of a perityphlitis.

Differential diagnosis carry out with appendicitis (see), secondary changes of a caecum at appendicitis, renal colic (see the Nephrolithiasis), hepatic colic (see. Cholelithiasis ), ginekol. diseases, with malignant new growths, a right-hand diverticulitis of a large intestine (see. Intestines ).

Treatment etiological and symptomatic. At T. an infectious etiology apply antibacterial agents. The patient appoint a diet, local thermal procedures, massage of intestines, at disturbance of digestion fermental drugs (see Colitis).

Forecast at timely treatment favorable.

Prevention comes down to the prevention of infectious diseases of intestines, timely treatment locks (see), sanitation of the inflammatory centers in an organism, to observance of a diet (see).

Bibliography: Berlin L. B. Chronic colitis, M., 1951; Levitan M. H., Fedorov V. D. and Kapul-ler JI. JI. Nonspecific colitis, M., 1980; V. P Is model. Stomach diseases, guts and peritoneum, page 116, Kiev, 1924; With and and to I N A. G. Postdizentery-ny colitis, M., 1970; Tashev T., etc. Stomach diseases, intestines and a peritoneum, the lane with bolg., page 593, Sofia, 1964; F and-nardzhyan V. A. Radiodiagnosis of diseases of a digestive tract, t. 2, Yerevan, 1964; Colenoff L. Rare ileocecal lesions, Amer. J. Roentgenol., v. 110, p. 343, 1970; H i 1 1 M. C. a. Goldberg H. I. Roentgen diagnosis of intestinal amebiasis, ibid., v. 99, p. 77, 1967; Teschendorf W., Anacker H. u. Thurn P. Ront-genologische Differentialdiagnostik, Bd 2, Stuttgart, 1978.

A. V. Frolkiye; H. U. Shniger (rents.).