特发性肠系膜静脉硬化性肠炎的认识进展

特发性肠系膜静脉硬化性肠炎(IMP)是缺血性结肠炎的罕见原因,临床上以腹痛、腹泻为主要表现,可伴有恶心、呕吐、粪便潜血试验阳性等非特异性症状,常导致诊断延误。IMP可基于影像学检查示肠系膜线状特征性钙化和独特的组织学示肠系膜静脉壁钙化确诊,目前其原因和发病机制尚不清楚。本文就近年IMP的认识进展作一综述。     

特发性肠系膜静脉硬化性肠炎临床特点分析

目的:分析总结特发性肠系膜静脉硬化性肠炎的临床表现、影像学及结肠镜检查特征、治疗及转归等,旨在加强临床医生对该疾病的认识。方法:报道1例北京医院消化科收治的特发性肠系膜静脉硬化性肠炎患者,该患者因腹痛腹胀、停止排便排气3个月,再发伴呕吐2 d入院,结合患者病史、症状、体征、影像学及肠镜结果等,考虑患者不完全性肠梗阻病因...     

特发性肠系膜静脉硬化性肠炎一例

患者女,62岁,因腹胀、呕吐伴停止排气、排便反复发作半年余,于2011年6月30日入上海交通大学医学院附属瑞金医院消化科.患者于2010年12月开始出现腹胀、腹痛,同时伴恶心、呕吐及排气、排便停止,反复发作5～6次,每次发作前1周左右排便次数减少,粪便成形,色黄.在外院辗转治疗,均诊断为病因不明的不完全性肠梗阻,予抗炎、补液、灌肠治疗后症状改善.发病期间无发热、呕血、腹泻、头晕、乏力等表现,发作间期粪便成形,色黄.     

特发性肠系膜静脉硬化性肠炎1例

正患者,男,62岁,因"右下腹痛半月"于2016年12月28日入我院消化内科。患者在半月前无明显诱因下出现右下腹间断性隐痛,无放射痛,与进食、大小便无相关,无呕吐、腹泻、发热畏寒、尿频尿急尿痛、腰痛。腹痛4d后患者来我院门诊就诊,查血常规WBC 9.7×109/L,HB 166.0g/L,PLT 222.0×109/L,C-反应蛋白21mg/L,全腹部CT平扫见升、横结肠肠壁肿胀增厚,周围血管钙化,见图1A,前列     

特发性肠系膜静脉硬化性结肠炎14例的临床、影像学和内镜特征分析

目的:探讨特发性肠系膜静脉硬化性结肠炎(IMP)患者的临床、影像学和内镜特征。方法:纳入2010年1月至2020年12月温州医科大学附属衢州医院(衢州市人民医院)收治的14例IMP患者。所有患者均行腹部X线、增强计算机断层扫描(CT)和内镜检查;3例行气钡灌肠造影检查,11例行内镜活体组织检查(以下简称活检)。14例I...     

静脉硬化性结肠炎诊治1例

静脉硬化性结肠炎是临床上罕见的以肠系膜上静脉分支及结肠壁静脉管壁广泛钙化并右半结肠壁增厚为主要特征的缺血性结肠炎。报告宁夏医科大学总医院消化内科收治的1例患者,旨在提高对该疾病的认识,为临床诊治提供参考。     

肝硬化并发食管静脉和直肠静脉曲张破裂出血1例

1病例介绍 病人男，56岁，呕血1h入院。有乙肝病史20年，发病肝硬化5年，既往曾有2次呕血史。经胃镜检查，诊断为食管静脉曲张破裂出血。入院体检：神志清，慢性肝病面容，BP100／70mmHg，P80次／min，颈部皮肤可见2枚蜘蛛痣，心肺听诊未见异常，腹平软，无明显压痛点，肝肋下未触及，脾肋下6cm，移动性浊音( )，双下肢无乳肿。实验室检查：Hb100g/L，     

Asymptomatic chronic intestinal ischemia caused by idiopathic phlebosclerosis of mesenteric vein

Phlebosclerosis of the mesenteric vein is a rare condition causing chronic intestinal ischemia, it has only been reported in Japan. A 56-year-old man with liver cirrhosis and hepatic tumor presented with phlebosclerosis of mesenteric vein without any abdominal symptoms. He was admitted for examination of suspected hepatic tumor. Abdominal plain x-ray films and computed tomography revealed calcification of the mesenteric vein. Barium enema revealed narrowing and thumbprinting from the cecum to transverse colon. On colonoscopic examination, blue-black vessels were visible in the terminal ileum, and hyperemic nodular mucosa with small irregular ulcers surrounded by dark purple mucosa was found from the cecum to transverse colon. The etiology of mesenteric vein phlebosclerosis is unknown, although a physical mechanism rather than inflammatory changes appear to be involved in this rare and usually progressive condition of chronic intestinal ischemia.     

Idiopathic mesenteric phlebosclerosis associated with long-term use of medical liquor:Two case reports and literature review

A 62-year-old woman was admitted to our hospital in2011 because of recurrent abdominal pain,nausea and constipation for six months.Computed tomography enterography(CTE)showed tortuous thread-like calcifications in the ileocolic vein and right colic vein,while colonoscopy revealed purple-blue mucosa extending from the cecum to the splenic flexure.Based on the results of these tests,the patient was diagnosed with idiopathic mesenteric phlebosclerosis(IMP).She had a history of Chinese medical liquor intake for one and a half years and her symptoms subsided after conservative treatment.In 2013,a 63-year-old male patient who presented with recurrent lower right abdominal pain,bloating,melena and diarrhea for fifteen months was admitted to our institution.Colonoscopy and CTE led to the diagnosis of IMP.He also used Chinese medical liquor for approximately 12 years.The patient underwent total colectomy and the postoperative course was uneventful.We searched for previously published reports on similar cases and analyzed the clinical data of 50 cases identified in PubMed.As some of these patients admitted use of Chinese medicines,we hypothesize that Chinese medicines may play a role in the pathogenesis of IMP.     

Idiopathic mesenteric phlebosclerosis associated with long-term use of Chinese herbs: a case report

A 59-year-old woman had been admitted to our hospital every two months for over a past year because of severe right abdominal pain. Colonoscopy revealed dark blue mucosa extending from the cecum to the transverse colon, and abdominal computed tomography showed wall thickening and linear calcification along the wall from the cecum to the transverse colon. Based on these findings, the patient was given a diagnosis of idiopathic mesenteric phlebosclerosis. Subsequently, we found that she had been a long-term user of a Chinese herbal product containing Gardeniae fructus for allergic rhinitis. After discontinuing the product, the patient has been free of abdominal pain for a year.     

Idiopathic spontaneous intramural hematoma of the colon: a case report and review of the literature

An 82-year-old man visited our hospital for abdominal discomfort and constipation lasting 3 days. He did not have a history of trauma or bleeding tendency. His laboratory studies showed slight anemia and inflammatory reactions, but other data including coagulation profiles were all normal. Computed tomography (CT) demonstrated a 6-cm high-density mass in the left upper quadrant and slight ascites. Contrast-enhanced CT revealed that the lesion was not enhanced. Colonoscopy could not detect the lesion. Laparotomy was performed because malignancy could not be ruled out. The mass was located in the transverse colon, and histologic examination showed intramural hematoma. Neither arteriovenous malformation nor a foreign body such as a fish bone was identified, indicating that the mass was considered to be idiopathic intramural colonic hematoma. We present this rare case and also a review of the literature.     

Chronic ischemic lesions of the colon caused by phlebosclerosis of ileocolic mesenteric vein

Phlebosclerosis of the mesenteric vein is a rare cause of intestinal ischemia. We report a case of chronic ischemic lesions of the colon caused by phlebosclerosis accompanied by marked venous calcification. A 77‐year‐old Japanese man with intestinal obstruction was admitted to Kanazawa University Hospital. Barium enema examination demonstrated narrowing in the right colon, while colonoscopy showed dark purple‐colored edematous mucosa and erosions from the cecum to the transverse colon. Computed tomography disclosed a substantially thickened colonic wall with intramural calcification and a calcified mesenteric vein in the right colon. As abdominal pain persisted, despite treatment with total parenteral nutrition for 3 months, a right hemicolectomy was performed. The pathological findings of the resected specimen were marked fibrous thickening of the submucosal layer, and fibrous thickening of the venous wall accompanied by hyalinization and calcification. These features indicated chronic ischemic lesion caused by phlebosclerosis.     

Spontaneous splenic rupture precipitated by cough: A case report and a review of the literature

Spontaneous rupture of a normal spleen without a history of trauma is a rare clinical entity. We report on a case of atraumatic splenic rupture in a 61-year-old man who presented to the emergency department for abdominal pain and hypotension. There was no evidence of hematologic or infectious disease involving the spleen. The chronic cough described by the patient was the main trigger for the rupture. Although, spontaneous splenic rupture is rare, it is vital that physicians consider this diagnosis when evaluating patients with abdominal pain and hypotension. Failure to consider splenic rupture could be catastrophic and early diagnosis is essential for a better outcome.     

Life-threatening spontaneous splenic rupture with systemic lupus erythematosus: case report and literature review

Although involvement of the reticuloendothelial system in systemic lupus erythematosus (SLE) is a well-recognised concomitant of the disease, spontaneous splenic rupture is an unusual occurrence. We observed a 54-year-old woman with SLE who had spontaneous splenic rupture during the late course of the disease and showed some changes histopathologically. The courses and the clinical characteristics of such patients are reviewed, and the diagnosis and treatment of these cases are discussed. Early evaluation for SLE patients with spontaneous splenic rupture should be considered and included in the differential diagnosis of acute abdomen, as it may affect follow-up and treatment, although the condition is rare.     

胰腺纤维钙化性糖尿病一例并文献复习

本文结合1例胰腺纤维钙化性糖尿病患者的临床资料和文献复习,分析该病的病因、临床表现、诊断标准及治疗、预后等。该病是一种继发于胰腺外分泌疾病的特殊类型糖尿病,主要见于热带发展中国家营养较差的青年人。其特点为胰腺内、外分泌功能同时受累,表现为胰管结石,胰腺钙化及糖尿病。治疗主要包括内科改善营养、控制血糖等及外科胰管取石。临...