Fecal vomiting is the discharge of brown vomit with a characteristic fecal odor. The symptom occurs in severe diseases of the digestive tract: advanced peritonitis, mechanical and dynamic intestinal obstruction of various origins, gastrointestinal fistula. To detect the cause of regurgitation of intestinal contents, a survey x-ray and ultrasound of the abdominal cavity, blood tests are performed. To eliminate vomiting, surgical interventions of various volumes are prescribed in combination with infusion therapy.
At the third (terminal) stage of inflammation of the peritoneum, total paresis of the gastrointestinal tract occurs, as a result of which a large amount of liquid feces accumulates in the intestine. As a result of reverse peristalsis, repeated painful vomiting opens, and the vomit quickly becomes fecal. Such symptoms are formed within 24-48 hours after the onset of the disease, if the patient has not consulted a doctor.
In addition to fecal vomiting with peritonitis, there is a characteristic earthy complexion, sunken eyeballs and drying of the mucous membranes. There are periods of impaired consciousness, during which vomit can enter the respiratory tract, causing asphyxia. The condition of a patient with fecal vomiting developed against the background of peritonitis is often extremely severe, he needs urgent help in an intensive care unit.
The condition occurs with local obstruction of any part of the intestine. Earlier onset of fecal vomiting in a patient is more evidence in favor of small bowel obstruction. The symptom is determined 1-2 hours after the onset of cramping pain in the navel. It is usually preceded by nausea. At first, the vomit contains partially digested food with bile impurities, after a while the person begins to vomit with liquid, fetid intestinal contents.
With colonic obstruction, vomiting of fecal masses develops 10-12 hours after the first symptoms (nausea, abdominal pain, stool retention) are detected. Patients complain of sharp painful tenesmus that is not accompanied by defecation. Pathognomonic is a wavy increase in pain, at the height of pain, the contents of the intestines are released from the mouth. The most common causes of mechanical intestinal obstruction with fecal vomiting are:
The pathological condition is due to a violation of the motor function of the intestinal wall. Typical causes are intestinal paresis in acute surgical diseases of the abdominal organs, prolonged bed rest, damage to the distal segments of the spinal cord. Fecal vomiting is preceded by nausea, periodic painful colic (with spastic obstruction) or constant arching pain in the abdomen.
Initially, during the urge to vomit, gastric juice and undigested food are released, gradually vomit with intestinal obstruction becomes brown and has a fetid odor. Then an indomitable vomiting of feces opens, which occurs as a result of massive intoxication of the body. After 1-2 days, the intensity of pain and the frequency of fecal vomiting decrease with the general extremely serious condition of the patient, which is an unfavorable prognostic sign.
When a pathological anastomosis is formed between the intestinal loops and the cavity of the stomach, feces mix with gastric juice, irritate the mucous membrane, which causes vomiting of intestinal contents. Patients with gastric fistulas also complain of excruciating nausea, constant smell of feces from the mouth, fetid belching. Peristalsis increases, persistent diarrhea worries. Rapid weight loss is typical.
The presence of fecal vomiting indicates a severe organic lesion of the digestive tract, so the patient is shown an examination by a surgeon. The general condition of a person often does not allow for the full range of diagnostic measures to determine the cause of the disease, therefore, they are limited to basic studies. Standard diagnostic methods for vomiting of intestinal contents:
The occurrence of fecal vomiting in a person is provoked by severe diseases with a high frequency of multiple organ failure and the risk of death, in which emergency medical care is indicated. To save the patient's life, it is critical to quickly establish why the disorder began. You can not self-medicate, take antiemetics or painkillers that can lubricate the clinical picture before the doctor arrives.
Drug therapy is prescribed regardless of the cause of the development of vomiting with intestinal contents. Treatment is aimed at restoring the volume of circulating blood and electrolyte disturbances, reducing endogenous intoxication, and preparing the patient for surgery. To eliminate the expansion of intestinal loops, decompression is additionally performed by nasointestinal intubation. For fecal vomiting use:
If intestinal obstruction is diagnosed, laparotomy is usually performed, followed by revision of the abdominal organs, dissection of adhesions, resection, or elimination of volvulus. Operations for peritonitis include revision, sanitation and other manipulations. In case of detection of a non-viable part of the intestine, its resection is performed and an anastomosis is formed. In a severe and threatening condition of the patient, they are limited to removing the colostomy with a future operation to restore the continuity of the intestinal tract.