溃疡性结肠炎并发坏疽性脓皮病1例

病例:患者女,52岁,因"反复腹泻伴下腹痛2个月,加重半个月"于2007年8月21日收治入院。患者于2个月前无明显诱因下出现腹泻,大便呈糊状,偶有鲜血,每日约5～6次。伴有下腹痛,排便后缓解。无畏寒、发热,无里急后重、关节肿痛、皮疹。于外院就诊后间断口服止泻药物治疗     

中西医结合成功诊治溃疡性结肠炎并发坏疽性脓皮病1例

患者刘某,女,54岁,主因"反复腹泻黏液血便10年,加重伴右足背肿痛溃破1周"于2017-08-22收入院。患者10年前因腹泻黏液血便于外院确诊"溃疡性结肠炎(ulcerative colitis,UC)"(未见肠镜报告),2008年曾行激素治疗(具体不详)。近年来患者每隔2~3年出现发作一次,见大便次数增多伴脓血,患者自行服用柳氮磺吡啶肠溶片可缓解。症状缓解后自行停药。     

溃疡性结肠炎合并坏疽性脓皮病一例

患者男，34岁。因间断腹泻、脓血便2年，加重伴发热、皮肤溃疡1周于2007年1月25日入院。入院前2年因饮食不当而出现腹泻，黄稀便每日10余次，偶见少量脓血，持续2～3d，自服中药缓解，平均每月发作1次。2005年曾经结肠镜确诊为“溃疡性结肠炎（累及全结肠、直肠）”。近1年常于下肢出现绿豆大小的脓疱，局部应用激素软膏可结痂痊愈。患者于入院前10d右下股内侧和头顶部先后出现黄豆大小的红色丘疹，顶部针尖大白色脓疱，自行应用激素类软膏无好转，继而破溃糜烂，中央坏死，1周内溃疡扩大，脓性分泌物多，有恶臭，触痛致跛行。脓血便加重，每日10余次，出血量10～40ml／次，伴脐周绞痛，里急后重，发热，食欲不振。     

以坏疽性脓皮病为主要表现的溃疡性结肠炎一例

患者女 ,6 3岁。因反复四肢坏疽 3年余 ,黏液脓血便 1周余入院。患者于 3年前开始出现上肢腕关节远端 ,下肢踝关节远端背侧皮肤点片状脓疱 ,延及手和脚趾 ,遂皮肤破溃并有气泡 ,可自行或通过外敷药膏等治疗好转 ,但常于手部溃烂尚未痊愈时 ,下肢又开始溃烂 ,交替反复发作。在多家医院皮肤科就诊 ,行皮肤分泌物细菌、真菌培养等检查均阴性 ,先后给予头孢他啶、莫匹罗星软膏及伊曲康唑等抗菌及抗真菌治疗。 10d前患者开始出现黏液脓血便 ,每日 10余次 ,3d前出现低热。入院体检 :体温 37.2℃ ,心肺无异常 ,腹部平坦 ,肝脾肋下未及 ,下腹部压痛 …     

溃疡性结肠炎并发坏疽性脓皮病的诊治护理1例

溃疡性结肠炎并发坏疽性脓皮病临床较为罕见.现报道1例男性患者,由门诊以肛瘘收入院,行肛瘘术中发现指套染有脓血,术后出现发热、脓血便、腹部溃疡面迅速扩大,行电子结肠镜检查并取活检诊断为溃疡性直肠炎,取皮肤组织病理并综合临床表现诊断为坏疽性脓皮病,经创面护理、美沙拉嗪及激素治疗44 d后腹部溃疡面趋于愈合,病情好转出院.由于溃疡性结肠炎并发的坏疽性脓皮病其临床表现及病理变化无特异性,导致早期诊断较为困难,且该病进展迅速、损害严重,应引起广大医护人员重视.     

溃疡性结肠炎合并皮肤严重坏死性脓皮病1例报告

溃疡性结肠炎合井皮肤坏死性脓皮病(Pyoder-ma gangrenosum)较为少见,严重病例更少.我科于1996年3月收治1例,经治疗后取得满意效果、现报告如下:患者,男,54岁,住院号:558243.因反复脓血便5年并右小腿溃疡进行性增大2月入院,无发热、疼痛.行走困难、间歇跛行等情况.入院前5年反复出现脓血便.结肠镜检发现直肠至横结肠肠腔变形,肠粘膜弥漫性充血、水肿,粘膜面高低不平,触及易出血,表面见糜烂和小溃疡.并有粘液和渗出物,诊断为溃疡性结肠炎.以柳氮磺胺嘧啶治疗,,因出现严重过敏反应而中止,而以中药治疗,未服用过激素.查体:神清,消瘦,贫血貌.心肺无异常.腹平软,未触及腹部包块,左下腹深压痛;无反跳痛,肝脾肋缘下未触及,双肾区无叩痛,NS(-).双下肢凹陷性水肿.右小腿前、内、外侧见一27×17cm溃疡,内见较多脓性分泌物,有痂皮附着,并可见少量新鲜     

溃疡性结肠炎合并脓皮病诊疗体会

溃疡性结肠炎(溃结)是结肠的一种非特异性炎症,有局部并发症和肠外表现,后者最常见的是关节痛、关节炎等,合并皮肤损害如结节性红斑和化脓性坏疽(脓皮病)国内外仅有少数的报道。我们曾成功诊治一名溃结合并脓皮病的患者,现将诊疗经过报告如下。     

坏疽性脓皮病合并HIV感染1例

坏疽性脓皮病（Pyoderma gangrenosum,PG）为一罕见的毁损性炎症性皮肤疾病,以疼痛性结节破溃继发进行性扩大性溃疡为特点,可原发,也可伴发其他系统性疾病。PG合并艾滋病病毒（Human immunodeficiency virus,HIV）感染较罕见,现报道1例。     

老年坏疽性脓皮病合并肺部多发结节1例

坏疽性脓皮病(pyoderma gangrenosum,PG)由Brunsting等于1930年首先报告,是一种以皮肤破坏性溃疡为特征的反应性炎症性皮肤病,多见于成人,其皮损形态有一定的特征〔1〕,临床少见,但病情较严重,多与一些系统性疾患有关。因常合并其他疾病,如溃疡性结肠炎、局限性肠炎、类风湿关节炎、骨髓     

糖尿病伴坏疽性脓皮病一例

患者,女性,６５岁,因反复皮肤溃烂１０个月,于１９９９年８月入院。患者于１９９８年１０月因进食海鲜后,右乳头内侧出现黄豆大的硬结,瘙痒,１个月后破溃,外用生肌膏、抗生素软膏无效。曾经切除缝合及植皮均未成功,全身先后出现６个硬结,溃烂,应损逐渐扩大。既往有糖尿病史４年,现皮下注射胰岛素并口服拜糖平血糖控制良好。１９８２年曾患“结肠炎”,现已愈。对青霉素、链霉素、先锋Ｖ、磺胺、扑热息痛等药过敏。体格检查：Ｔ３６． ６℃,Ｐ７５次,Ｒ１６次,ＢＰ １２０／８０ｍｍＨｇ。左臂、右肩胛外侧、左臀部、左大腿内…     

Atypital localisation of pyoderma gangraenosum in patient with ulcerative colitis

The authors present a case of 61-year-old man with ulcerative colitis and with extraintestinal manifestation of the disease in the form of pyoderma gangraenosum. Multiple skin defects, which developed in atypical localisation (extensive affection of facial and hairy parts of the head) in patient with chronically active form of ulcerative colitis were complicated with bacterial contamination of methicilin-resistant strains of Staphylococcus aureus. After application of the parenteral feeding, corticotherapy and targeted antibiotic therapy the subjective and objective status of the patient markedly improved, stool frequency was reduced, admixture of blood in the stool disappeared, temperatures fell back and there was a decrease in activity of non-specific bowel inflammation in laboratory findings. However endoscopic examination of the intestine confirmed the finding of chronically active ulcerative colitis with ulcerations and bridging polyps. Patient was indicated to total colectomy, but he refused it.     

Ulcerative colitis or amebic colitis--a case report

The large intestine reacts relatively monomorphically to different stimuli. From this differential-diagnostic problems may result. The history of a patient is described which could be pursued retrospectively and prospectively over 14 years and during the course of which the correction of the diagnosis ulcerous colitis into chronic relapsing amoebic colitis was necessary. As a conclusion is emphasized that in every symptomatology of colitis primarily bacterial and parasitologic examinations of the faeces should be brought about and it must be also thought of spontaneous amoebic infections in our country.     

Ulcerative colitis associated with Weber-Christian panniculitis and musculitis: A case report

A case of 22-year-old man suffering from ulcerative colitis, in whom Weber-Christian panni culitis and musculitis occurred simultaneously, is reported. He had suffered from ulcerative colitis for 7 years and he again had bloody stools 1 month before being admitted. Two weeks before admission, large (2–4cm) subcutaneous tumors appeared. Weber-Christian panniculitis, musculitis, and active stage ulcerative colitis were diagnosed. All the symptoms went into remission after steroid therapy. The possibility of the existence of a common antigen in enterobacterial wall, colonic epithelium, and adipose tissue was suggested.     

胶原性肠炎1例

胶原性肠炎是一种少见的肠道炎症性疾病,诊断并不困难,但容易漏诊.本例患者表现为顽固性的水样腹泻,经过多学科会诊,最终诊断为胶原性肠炎,经激素治疗后症状完全缓解.     

Ulcerative colitis with inflammatory polyposis in a teenage boy:A case report

Ulcerative colitis in addition to inflammatory polyposis is common.The benign sequel of ulcerative colitis can sometimes mimic colorectal carcinoma.This report describes a rare case of inflammatory polyposis with hundreds of inflammatory polyps in ulcerative colitiswhich was not easy to distinguish from other polyposis syndromes.A 16-year-old Chinese male suffering from ulcerative colitis for 6 mo underwent colonoscopy,and hundreds of polyps were observed in the sigmoid,causing colonic stenosis.The polyps were restricted to the sigmoid.Although rectal inflammation was detected,no polyps were found in the rectum.A diagnosis of inflammatory polyposis and ulcerative colitis was made.The patient underwent total colectomy and ileal pouch anal anastomosis.The patient recovered well and was discharged on postoperative day 8.Endoscopic surveillance after surgery is crucial as ulcerative colitis with polyposis is a risk factor for colorectal cancer.Recognition of polyposis requires clinical,endoscopic and histopathologic correlation,and helps with chemoprophylaxis of colorectal cancer,as the drugs used postoperatively for colorectal cancer,ulcerative colitis and polyposis are different.     

A case of pyoderma gangrenosum with ulcerative colitis treated with combined approach: Infliximab and surgery

Pyoderma gangrenosum (PG) is an ulcerating noninfectious disease of the skin seen in 1–2% of patients with inflammatory bowel disease (IBD). The pathogenesis of PG has yet to be determined, but may be related to abnormal T cell responses and the production of TNF-α, a pathway also involved in IBD pathogenesis. Infliximab, a chimeric monoclonal antibody to TNF-α, is used to treat moderate to severe IBD and several case reports and studies suggest the efficacy of infliximab in the treatment of PG. The surgical approach to PG is reserved to a few selected cases. We report here the case of a patient with ulcerative colitis (UC) and PG localized on the left breast, treated with a simultaneous combined medical and surgical approach.     

急性血吸虫病出现类白血病反应1例

1临床资料患儿,男,11岁,江西省高安市人,2002年9月10日因发热、咳嗽伴腹泻,在附近卫生院就诊无效,后转人民医院诊治。血常规:WBC43×109/L,N88%,L11%,B超提示肝大,回声增强。给予“头孢类、大环内脂类”等抗生素治疗1周后,患者仍高热不退,咳嗽不止,白细胞不降。医生建议作骨髓穿刺,排除“白血病”,因家属拒绝而转入本院。询问病史,患者暑期曾到江西省九江市波阳县莲湖乡(血吸虫病疫区)嬉水、游泳。查体:T38.7℃,P95次/min,R20次/min,BP13/10kPa,咽部轻度充血,扁桃体不大,肝剑突下3cm,质中。血常规:RBC4.0×1012/L,WBC42×109/L,E30…