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缺血性肠病的病理观察

Clinicopathologic Observation of Ischemic Bowel Disease

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【作者】 田学武赵永辉

【Author】 TIAN Xuewu,ZHAO Yonghui Department of Pathology,Dongguan Changping Hospital,Dongguan 523573,China

【机构】 广东省东莞市常平医院病理科

【摘要】 目的探讨缺血性肠病的临床及病理特征。方法对18例缺血性肠病进行临床、病理学分析。结果缺血性肠病以60岁以上老年人多见,临床主要表现为腹痛、血便及腹泻等,早期内镜检查主要表现为结肠黏膜水肿、充血、糜烂及溃疡;病理学改变主要包括肠壁充血、水肿、出血、变性坏死及含铁血黄素细胞浸润等,并伴有不同程度的炎症反应。结论缺血性肠病临床表现无特异性,误诊、漏诊、病死率高;中老年患者出现急性腹痛、便血时,及时行结肠镜检查和病理活体组织检查是缺血性肠病早期诊断的主要方法 。

【Abstract】 Objective To investigate the clinical and pathologic features of ischemic bowel disease.Methods The clinical and pathologic data of 18 cases of ischemic bowel disease from 2002 to 2008 were reviewed.Results Of the 18 cases,15(83.3%) were over 60 years old.Ischemic bowel disease usually presented with sudden onset of abdominal pain,hematochezia and diarrhea.Colonoscopy showed edema,congestion,erosion and ulceration of mucous membrane at early stage.The main pathologic features of ischemic bowel disease are hyperemia,edema,hemorrhage,degeneration and necrosis and the infiltration of hemosiderin-laden macrophages of bowel wall with various degrees of inflammatory reaction.Conclusion Ischemic bowel disease has no specific clinical manifestations,which will lead to misdiagnosis,missed diagnosis and high mortality rate.Ischemic bowel disease should be suspected in all elderly patients with acute onset of abdominal pain and hematochezia.Colonoscopy and biopsy as soon as possible is the main method for diagnosis of ischemic bowel disease.

  • 【文献出处】 医药论坛杂志 ,Journal of Medical Forum , 编辑部邮箱 ,2010年10期
  • 【分类号】R574
  • 【被引频次】5
  • 【下载频次】157
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