Retroperitoneal lymphadenitis

　　The retroperitoneal space is a potential gap, extending from the diaphragm above to the pelvic diaphragm below; the main anterior boundaries include the parietal peritoneum of the posterior abdominal wall, the bare area of the right liver, part of the duodenum, ascending colon, and rectum; the posterior part includes the vertebral bodies, psoas major, quadratus lumborum, and the origin of the transversus abdominis muscle from the lumbar fascia. Below the iliac crest, there are also the sacrum, psoas major, and piriformis muscles; the lateral boundaries are defined by the iliac muscle and obturator muscle. The main organs within the gap are the kidneys, ureters, adrenal glands, and pancreas, as well as some large blood vessels, lymphatic tissues, and nervous tissues, rich in fatty and loose connective tissues.

　　Some structures are easily exposed peritoneally, such as the adrenal glands, kidneys, ureters, lumbar sympathetic chain, splenic arteries and veins, renal arteries and veins, abdominal aorta, inferior vena cava, common iliac arteries and veins, internal iliac arteries and veins, pancreas, and inguinal canal, etc.

　　There are many different theories, and it is generally believed that:

　　1. Bacterial infection:It usually originates from gastrointestinal tract infections or infections in other organs through systemic blood circulation.

　　2. Viral infection:It is mostly caused by upper respiratory tract infection or mumps and other conditions.

　　3. Tuberculosis infection:Tuberculous retroperitoneal lymphadenitis is more common, which can be primary in retroperitoneal lymph nodes or secondary to tuberculosis in the gastrointestinal tract, abdomen, and lungs.

　　Gastrointestinal, abdominal, and pulmonary tuberculosis, intestinal paralysis, pyloric obstruction, portal hypertension, biliary obstruction, and fistula formation, and other complications.

　　Retroperitoneal lymphatic tuberculosis can disseminate throughout the body, leading to tuberculosis in other parts. In severe cases, bacterial toxins can cause gastrointestinal dysfunction, leading to decreased or absent intestinal peristalsis, intestinal gas accumulation, increased pressure, and impaired gastrointestinal blood circulation, insufficient blood and oxygen supply, forming a恶性 cycle. Severe abdominal distension and other symptoms of intestinal paralysis, biliary obstruction, and other complications may occur.

　　1. Acute retroperitoneal lymphadenitis

　　It is mainly characterized by high fever and chills, accompanied by abdominal pain, distension, back and lumbar pain, nausea, vomiting, and other symptoms. The body temperature can reach 39-40°C, presenting as remittent fever or persistent fever. Abdominal tenderness and rebound tenderness may be observed during examination, but muscle tension is not obvious. Severe cases may have signs of intestinal paralysis, back and lumbar tenderness, and an elevated white blood cell count.

　　2. Chronic or tuberculous retroperitoneal lymphadenitis

　　Tuberculosis bacteria can invade retroperitoneal lymph nodes, which can be one of the local components of the primary complex, or a result of widespread dissemination of tuberculosis bacteria. The affected lymph nodes can be treated without symptoms, and finally calcify. Some lymph nodes may become enlarged, experience caseous necrosis, and even form abscesses. The onset of the disease is often insidious, with vague or even absent symptoms. The main symptoms are persistent or intermittent hidden pain or distension in the abdomen, accompanied by low fever, nausea, vomiting, abdominal distension, loss of appetite, and other symptoms. The abdominal pain of this disease may present as intermittent attacks, and treatment with anti-infection or anti-tuberculosis and antispasmodic drugs often has poor results. Some reports have mentioned that proximal ureteral and renal compression or displacement, pyloric obstruction, gastric wall stiffness, duodenal retraction or stenosis, expansion of the duodenal loop, and translocation of the transverse colon have been observed. Rare manifestations include leg swelling, chylous ascites, portal hypertension, biliary obstruction, and fistula formation. Abdominal examination may reveal a mass or localized fullness, deep tenderness, no muscle tension, and active bowel sounds.

　　Patients should pay attention to labor protection in their daily life, avoid外伤, and if there is skin injury, it should be treated in time to prevent the spread of infection. If they have tonsillitis, caries, finger infection, athlete's foot, carbuncle, abscess, and other conditions, they should receive appropriate antibiotic and anti-inflammatory treatment or treatment to control infection. They should also pay attention to physical exercise and strengthen their physical fitness.

　　Controlling the source of infection, especially early reasonable chemotherapy for sputum tuberculosis-positive patients, can reduce the amount of tuberculosis bacteria in the sputum in the short term, and even disappear. It is forbidden to spit on the ground, and the sputum, daily necessities, and surrounding objects of patients with positive bacteria should be disinfected and properly disposed of. Indoor ultraviolet light can be used for disinfection.

　　1. X-ray:The traditional X-ray examination of large blood vessels is the most commonly used and preferred imaging examination method, which can clearly diagnose many diseases.

　　2. B-ultrasound:It can obtain cross-sectional images of the organs to be examined, can be directly observed visually, and can clearly show the structure of retroperitoneal lymph nodes.

　　3. CT:CT is different from X-ray imaging. It scans the human body section with X-ray beams, obtains information, and obtains reconstructed images after computer processing. The images displayed are cross-sectional anatomical images, and their density resolution is significantly better than X-ray images. This significantly expands the scope of human body examination, improves the detection rate of lesions, and the accuracy of diagnosis.

　　4. Tuberculosis antibody or tuberculin test.

　　Nutritional therapy for retroperitoneal lymphadenitis

　　1. Clam Flower Steamed Rock Sugar:Dried clam flower 30 grams, appropriate amount of rock sugar (crushed), water 300 milliliters, steam in a bowl, eat 1-2 times. Suitable for the early stage of acute lymphadenitis.

　　2. Clam Flower and Date Soup:Dried clam flower 25 grams, 5 dates, water 400 milliliters, decoct to 300 milliliters. Eat dates and drink the soup 1-2 times. Suitable for the early stage of acute lymphadenitis.

　　3. Clam and Kelp Soup:Clam meat 100 grams, kelp 50 grams, water 500 milliliters, boil, add ginger slices and refined salt, then cook for another 20 minutes, add monosodium glutamate, pour sesame oil. Eat clam meat and kelp 1-2 times while hot, drink the soup. Suitable for lymphadenitis and thyroid swelling.

　　I. Drug Treatment:

　　It mainly gives antibacterial or traditional Chinese medicine treatment according to the nature of infection. For those with tuberculosis, regular anti-tuberculosis treatment should be given, but the course needs 1-2 years, and drainage is needed for larger abscesses. Oral isoniazid for 1-2 years, accompanied by systemic toxic symptoms or tuberculosis lesions in other parts of the body. Add sodium aminosalicylate or rifampicin or add streptomycin intramuscular injection.

　　II. Surgical Treatment:

　　For those with localized tumors or adjacent organs that are compressed and ineffective after non-surgical treatment, surgical resection can be adopted.