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Vutreshni bolesti 1975

[Changes in the large intestine after cholecystectomy].

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V Ianchev
E Stoianova

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Aiming at the establishment of the type and incidence of morphological and tonometric large intestine changes post cholecystectomy--64 patients were examined, 36 aged up to 50 and 28 over 50 by means of rectoromanoscopy, transrectoscopic biopsy, X-ray examination (passage and irigoscopy), balloon signography and anal tonometry. Morphological changes--catarrhal type (34.38%) were established to originate often in large intestine post cholecystectomy. Tonometric changes were observed in 56.25%. They are: hypertonic hypokinesia (45.32%) and hyperkinesia (10.93%). All patients with morphological changes are also and with tonometric disturbances. Ergo, 21.87% of the patients are with tonometric disturbances without pathomorphological changes. In the correlation of the morphological with tonometric changes, the catarrhal changes with hypertonic hypokinesia were established to be the most frequently met morbid combination and considerably more rarely--"catarrhal changes with hyperkinesia". Normotonia and normokinesia are most often found in cases with normal mucosa and considerably less rarely--hypertonic hypokinesia. The morphological as well as the tonometric changes are more frequent with age advancing of the patients and the growth of the time post cholecystectomy. Subjective complaints are reported from 56.25% of the patients. The most frequently met are feeling of heaviness in the abdomen, more rarely meteorism and rumble of the intestines and most rarely--pains along the large intestine. Objectively pain findings in the physical examination of abdomen and large intestines are established in 56.25% of the patients. Meteorism is most frequently established and relatively more rarely spastic large intestine and pain with its palpation (almost with equal frequency). Defecation is normal in 29.69% of the patients. The rest complain more often of diarrhea (45.32%) and more rarely of constipation (25%).

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