Download Chapter 6 Stool tests

Chapter 6 Stool tests

Stool examination is a basic method for
getting clues of inflammation, bleeding,
obstruction, tumor and parasite infection
in gastrointestinal tract and digestive
system in clinic. This part of tests
include the general property of stool,
microscopic examination , chemical
(occult blood) test and bacteriological
tests.
•General property of stool
•Microscopy
•Occult blood test
•Bacteriological
examination
General property of stool
•watery stool: infectious and non-infectious diarrheas
•mucus stool: inflammatory diarrheas
•pyohemochezia stool: bacterial dysentery, ulcerative
colitis, Crohn’s disease,rectum carcinoma, colon
carcinoma
•hematochezia stool:
bloody diarrhea, hemorrhoid
ischemic colitis, amebie dysentery, rectocolitis
•melena or tarry stool: a sign of bleeding from an upper
digestive tract: gastric ulcer, carcinoma of stomach
•kaolin stool: biliary obstructio
Microscopy
Cells:
• WBC:normal 0~1/HP, >15/HP inflammation
• RBC:normal:0, RBC (+~+++) : dysentery, carcinoma of
GI, ulcerative colitis
• macrophage:normal: 0, (+): colitis , bacterial dysentery
• tumor cell: colon carcinoma, rectum carcinoma
Food residue:
Ovum of parasite : roundworm, hookworm , tenia
Occult blood test
GI bleeding is a common clinical problem.
Blood loss ranges from occult bleeding of
which the patient is unaware to massive
bleeding that anyone would notice( melena or
bloody stool). Positive occult blood test is
usually due to chronic GI blood loss, both
upper and lower GI lesion such as peptic ulcer,
stomach carcinoma, and colon carcinoma. It is
a screening test for digestive carcinoma
especially for elderly people .
Case analysis

History and physical examination:
This
patient was a 68-year-old man. For the
previous 3 months he had complained of
incresingly severe dizziness, shortness of
breath, weakness and melena stool. On
admisson to the hospital , the body
temperature was 37.6 C. Slightly enlarged
lymphnodes were palpable in the rght axilla
and posterior cervical areas. The spleen and
liver are not enlarged.
Laboratory data: Hb 75g/L, WBC 15×109/L,
PC 80×109/L, stool: tarry and soft, RBC
1~3/HP, WBC 2/HP, no special cell was found.
Question:
•What do you think this patient probably suffer
from ?
•What do you plan to do next?
•why does this patient had developed medium
anemia?