Bowel disease


This section presents only a few anatomical and physiological features of the intestine relevant to clinical practice.
The intestine is the main Department of the digestive tract, starting from the pylorus of the stomach (pylorus) and ending anal hole. There are the small intestine (intestinum tenue) and the colon (intestinum crassum). The first is subdivided into short duodenal intestine (duodenum), skinny (jejunum and the ileum (the ileum), the second - on a blind gut (caecum), colon (colon) and direct (rectum).
Duodenum is in the small intestine little isolated place, because of its anatomical and physiological characteristics. Except its upper part (pars superior), directly adjacent to the gatekeeper, all duodenum is located retroperitoneale. In descending Department following pars superior, open pancreas and common bile ducts. Duodenum is in close proximity to a number of important bodies: adjacent to the stomach, as its continuation, it borders in its upper descending and horizontal part of the head, and rising from the body of the pancreas, is near the right lobe of the liver, aorta, right adrenal, inferior Vena cava. The total length of the duodenum is equal to 20-30 cm, and its diameter varies from 3 to 5 see For a short distance in the duodenum is the neutralization of acidic chyme from the stomach, the concentration of hydrogen ions is reduced to about 100,000 times. These features cause a close connection between the stomach and the duodenum, and the second between the duodenum and is in close proximity to her authorities. This relationship is reflected in the character of pathological processes with the defeat of this part of the small intestine and put diseases of the duodenum in a rather special position in relation to other parts of the small intestine.
The length of the remaining part of the small intestine is about 6 m, the longest Department of the digestive tract. However, if the person to enter the probe length 3 years (with a little weight at the end), then the end it usually comes in a blind gut. Thus, the length of the small intestine from the dead more than the living, almost twice. This feature can be associated with the tone (the degree of reduction) longitudinal muscle fibers in the bowel wall. In this regard, the length of the small intestine varies both in norm and in pathology widely. The small intestine towards colon tapering gradually from 4.8 to 5 cm in diameter at its proximal to 2.7-3 cm in the distal. The small intestine is the mesentery and is administered intraperitoneally.
The duodenum is top located IPR, of the three, and later of the two shells, and the wall of the small intestine everywhere consists of three shells: serous, muscle and mucous. Muscular layer consists of two layers of muscle fibers: outer longitudinal and inner - ring. The mucous membrane is the most important functionally part of the body. In the duodenum mucous membrane consists of epithelium, own layer and muscle layer (Fig. 33). On the inner surface of the mucous membrane are protrusion finger shapes - fibers. The length of the fibers is 0.3-0.5 mm, Under the villi in its own layer of mucous membrane are crypt - tubular deepening lined epithelium. The mouth of the crypt opens in the space between the fibers and the bottom reaches the muscle layer of mucous membranes. The number of crypts approximately twice more than the number of fibers.
Muscle layer of mucous membrane consists of several thin muscle fibers.
Submucosal shell is a loose connective tissue, in which are thicker duodenal (brunnerova) gland.

Fig. 33. The mucosa of the duodenum healthy person.

Villi and the crypt is lined with a single layer of cylindrical epithelium, in which there are two types of cells (kamchatyi and the goblet). In addition, at the bottom of the crypts you can find the so called apical-grained cells (cells Panet).
Compared to the duodenum villi of the mucous membrane of the small intestine is somewhat longer and reach of 0.8-1.3 mm In the submucosal layer guts no brunnerova glands.
The length of the colon is the last digestive tract is equal to 120-150 see its Diameter in the initial section (in the field of the caecum) is 7-8 cm, and in the distal (downward Department of the colon) - 4-5 see a Large part of the colon is administered intraperitoneally, and the vessel wall it consists of three shells: serous, muscle and mucous. In the muscle membrane longitudinal fibers are collected in the form of three longitudinal strips. The spaces between the "ribbons" are formed protrusion (haustra coli). The mucous membrane consists of epithelium, own layer and muscle layer of mucous membranes. The epithelium covers not only the surface of the mucous membrane, but also the crypt, the bottom of which there is a multiplication of cells by mitosis. The epithelium consists of two kinds of cells: kamchatyi and goblet, the latter much more than the small intestine.
The blood supply to the intestine is mesenteric arteries a. mesenterica cranialis and a. mesenterica caudalis, turning into smaller vessels (respectively AA. jejunalis and AA. colica media). Venous blood from the intestines, as well as all unpaired of abdominal organs, going in v. portae. Part of venous blood from the rectum in vv. hemorrhoidalis flows into the inferior Vena cava (through internal private parts Vienna). This way of venous blood, as well as through the veins of the esophagus, and is particularly important in the development of portal hypertension.
Nervous regulation of activity of the bowel is meisnerova plexus, which is located in the submucosa of the, and HORBACHOV - in the muscle membrane. In addition, the activity of the intestine effect of parasympathetic and sympathetic nervous system and parasympathetic division enhances motor activity of the bowel and increased secretion its mucosa, and sympathetic - has the opposite effect.

Research methods
Chronic diseases
Diseases of the duodenum
      Chronic duodenitis
      Duodenostaza, dyskinesia of the duodenum
      Anomalies of development of duodenal ulcer
      Tumors of the duodenum
Diseases of the small intestine
      Chronic enteritis
      Whipple's Disease
      Disaccharidase deficiency
Diseases of the colon
      Chronic colitis
      Ulcerative colitis
   Crohn's Disease
      The etiology and pathogenesis
      Pathologic anatomy
      Clinical symptoms
      Radiological changes
      Diagnosis and differential diagnosis
      For, complications
Neoplasms of the intestine
      Tumors of the duodenum
      Tumours of the small intestine
      Tumours of the large intestine
      Tumours of the rectum
      The etiology and pathogenesis
      Pathologic anatomy
      Clinical symptoms
      Carcinoid syndrome
      Research methods
      The course and prognosis