蓖麻油引起急性出血性坏死性肠炎1例

患者,女,43岁,因反复下腹痛、腹泻2年余,一周前肠镜检查诊断为“乙状结肠息肉”,于1996年10月28日收入院,入院后拟行 PSD 术,PSD 术前晚8:00作肠道准备时服用蓖麻油30ml,半小时后突然出现剧烈腹痛,以下腹痛为主,予肌注654-2 10mg 等处     

阿莫西林相关出血性结肠炎1例并文献复习

1 病例介绍 患者,女,43岁.因黑便5d、加重1d入院.患者5d前感冒后至当地诊所就诊,口服阿莫西林胶囊(阿莫仙,联邦制药)1次,共1.0g后解黄褐色稀水便,1次/d,量约100 g,无呕血,病初不伴腹痛、腹胀,无恶心、呕吐.入院头天突发腹部绞痛,以下腹明显,解黑色成形便1次,其后反复解暗红色血便,共约10余次,伴恶...     

羟氨苄青霉素引起出血性肠炎1例

患者女性 ,3 6岁。因反复发作上腹部胀痛 2个月余 ,伴有烧心、嗳气等症状 ,经门诊胃镜检查诊断“十二指肠球部溃疡活动期”住院治疗。镜检试纸法测HP( +)。入院后给予洛赛克 40mg ,每日 2次 ,静脉点滴 ;莫沙比利 5mg ,每日 3次 ,餐前 3 0min口服 ;阿莫西林 (羟氨苄青霉素 ) 0 5g ,每日 3次口服。住院第 9天 15 :3 0时 ,患者突然出现下腹部剧烈疼痛 ,随后排稀黄便 ,便中有鲜血 ,此后至次日上午排 10余次鲜血便 ,每次便血量 10～ 2 0mg ,便前腹痛 ,便后略缓解 ,无发烧及里急后重 ;粪常规示 :鲜血便 ,血常规示 :WBC 5 6× 10 9/L ,HB 13 …     

急性出血性坏死性肠炎早期误诊1例报告

患儿,男,4岁,以“间断发热,呕吐5天,抽搐1次”为主诉于1994年11月13日住我院小儿科诊治。病程中无腹疼、腹泻及大便带血,无呕吐咖啡样胃内容物。查体:T 37℃,精神萎靡,嗜睡,呼之不应,压眶有反应,面色轻微发绀。心肺听诊正常,腹软,脐周压痛轻。化验:血WBC 17.5×10~9/L,N0.52,LC0.47,血生化及脑脊液生化检查正常,脑电图示重度弥散性异常。按“抽搐原因待查,病毒性脑炎?”给予降颅压,抗感染,对症治疗。住院期间患儿频繁抽搐,上述症状加重,多次呕吐咖啡样物质(化验:RBC+++,OB+),腹痛有所加重,不伴腹泻及血便。给予对症处理,3天后患儿出现黄疸。肝功示:     

急性出血性坏死性肠炎一例

患者男，52岁。因进食自制泥螺后出现腹痛、腹泻伴发热2d就诊。患者进食泥螺2h后突然出现中上腹阵发性绞痛，继而开始黄水样腹泻，后转为赤豆汤样。经当地抗感染等处理，腹痛及腹泻稍缓解，但自觉全身不适，厌食，无呕吐、里急后重。体检：体温37．8℃，血压125／75mmHg，精神稍萎，心肺无异常，中上腹有压痛，无反跳痛。     

抗生素相关性出血性肠炎的临床及内镜特点

抗生素相关性出血性肠炎是一种较少见的疾病 ,国外文献早在 2 0世纪 70～ 80年代就有报道 ,但国内鲜见报道 ,为羟氨苄青霉素 (阿莫西林 )及其他青霉素衍生物治疗后发生的少见并发症。临床表现为血性腹泻伴或不伴有腹部绞痛 ,早期结肠镜检查有助于明确诊断。我们分析 5例抗生素相关性出血性肠炎 ,研究其临床表现、实验室检查、内镜表现及治疗预后 ,提高医生对本病的认识。一、资料与方法在 1997年 2月至 2 0 0 2年 11月期间 ,因急性血性腹泻或血便来诊的患者 4～ 36h内行电子结肠镜检查。仔细询问患者的药物服用史 ,尤其是发病前 1周内的用药…     

急性出血性坏死性肠炎13例报告

急性出血性坏死性肠炎,近几年屡有报告,山东地区报告者尚不多,我院自1964年7月至65年6月遇到13例,现报告如下: 临床分析 13例中,男10例,女3例,均为农民。年龄最小者14岁,最大者66岁。发病季节都在5、6、7月份。临床主要表现,12例有饮食不当,仅一例与饮食无关。起病急骤。腹痛最先发生,部位不定,多为脐周围,次为右下腹,再次为上腹,晚期全腹;疼痛性质为剧烈的持续性绞痛或钝痛。随后出现腹泻,初为黄色水样便进而为暗红色血水样便或稀豆酱样便。腹泻次数多少不一,每日7-12次,多达20余次。其中两例腹泻每日4-6次黄水样便,次日大便豆酱样时,每日只2次。血水样便时,大便次数均较多。可见大便颜色与大便次数有密切关系。13例中12例无里急后重或肛门坠胀感;此因病变位置高,未引起直肠括约肌的刺激症状,这是与痢     

急性出血性坏死性肠炎

急性出血性坏死性肠炎为肠道急剧坏死与出血的疾病,病程凶险,病死率高,临床表现复杂,容易与许多疾病混淆,误诊率高。主要临床表现①脐周或全腹部有阵发性绞痛或持续痛阵发性加剧,并有压痛或呈肌紧张及反跳痛。②腹痛伴有频繁呕吐,吐物为黄     

糖尿病并发急性出血性坏死性肠炎二例

例1男、50岁。入院前1周始无明显诱因发热、伴恶心、呕吐,脐周持续性疼痛阵发性加剧,粘糊状大便4～6次/日,,无里急后重感。入院后解果酱样稀便9天,总量约1500ml。有“糖尿病”史7年,常服D860。体检:体温38.2℃,脉搏100次/分,呼吸20次/分,血压14/8kPa。轻度脱水征,心肺正     

Autoimmune pancreatitis associated with hemorrhagic pseudocysts: a case report and literature review

Autoimmune pancreatitis (AIP) is a new category of pancreatic diseases. AIP associated with pseudocysts is rare; only 8 cases have been reported in the literature. A 63-year-old man was admitted to our department because of upper left abdominal pain and back pain. Various imaging studies demonstrated swelling of the tail of the pancreas with hemorrhagic pseudocysts. The patient underwent a surgical operation. A pancreatogram of the specimen revealed total occlusion of the main pancreatic duct in the tail of the pancreas. Histopathological examination revealed that it was AIP with hemorrhagic pseudocysts.     

Antibiotic-associated segmental hemorrhagic colitis: a case report]

Pseudomembranous colitis is a well known complication of antibiotic therapy. Only recently few cases of another form of an antibiotic-associated colitis, the acute segmental haemorrhagic penicillin-associated colitis, have been described. We report another case and point out the importance of early colonoscopy to distinguish the disease from the pseudomembranous colitis.     

Small intestinal obstruction resulting from ischemic enteritis: a case report

A 69-year-old male was admitted to our institution because of a sudden onset of vomiting and abdominal distention. His past history of illness included femoral head fracture, congestive heart failure and ischaemic colitis. Plain abdominal computed tomography revealed extensively dilated small intestinal loops with a calibre change around the end of the ileum. Small intestinal obstruction was diagnosed and a transnasal ileus tube was placed. The ileus tube was constantly moved towards small intestine until it reached the distal ileum. Contrast medium from the ileus tube revealed a distal ileal stricture. Subsequently, transanal single balloon enteroscopy was performed to inspect the stricture, revealing a circumferential and afferent tubular ulcer in the distal ileum, 5 cm from the ileocecal valve; gastrofluorography confirmed the stricture. Although the stricture was dilated on several occasions using balloon catheters, the stricture could not be improved. However, during the treatment, his general condition worsened over time; thus, surgical treatment was decided. Operative findings revealed several circumferential ulcers with a clear margin 5–28 cm from the ileocecal valve: all lesions were successfully resected. Pathological findings were consistent with ischaemic enteritis. We report a case of small intestinal obstruction resulting from stenotic ischaemic enteritis.     

A case of massive hemorrhagic enteritis due to rotavirus

We described a 8-month-old boy of massive hemorrhagic enteritis due to rotavirus complicated by shock. As far as we know, this case is the first patient who developed vascular collapse from the gastrointestinal tract bleeding by rotavirus infection. Clinicians should be alerted to the possibility of the occurrence of severe hemorrhagic enteritis as a life threatening complication in rotavirus induced enteritis.     

Multiple small bowel ruptures due to ischemic enteritis： A case report

A rare case of multiple small bowel ruptures due to ischemic enteritis (ISE) is reported. The patient was admitted to the hospital with acute abdominal pain followed by bloody diarrhoeas. Preoperative colonoscopic findings were similar to those presented in Crohn's disease. Intraoperatively, ischemic lesions and multiple ruptures were localized at the jejunum and the proximal ileum. Histopathological examination of the resected bowel segment established the diagnosis of ISE. Although ISE is not common, concurred multiple ruptures of the small bowel is a rare but actual complication.     

Myopericarditis in a patient with Campylobacter enteritis: a case report and literature review

Myocarditis sometimes occurs as a complication of bacterial infection, including enteric infections caused by Salmonella, Shigella and Yersinia. Only a few cases of Campylobacter-associated myocarditis are known. We describe a 47-y-old patient with myopericarditis in association with Campylobacter spp. enteritis, and review similar cases previously described in the English literature.     

Severe hemorrhagic cystitis associated with prolonged oral cyclophosphamide therapy: case report and literature review

Severe hemorrhagic cystitis associated with oral cyclophosphamide (CYP) therapy has rarely been reported in the past 20 years, probably because this condition has largely disappeared because of the use of shorter courses of CYP, either oral or IV. Herein, we describe a patient who received 309 g of oral CYP over a 4-year period to treat Wegener's granulomatosis (WG) that initially involved brain, lung, and kidney. She came under our care for the first time when she presented with a one-day history of oliguria and passing blood clots. Severe hemorrhagic cystitis was present. It eventually required cystectomy. Despite her massive CYP exposure her kidney biopsy showed acute crescentic glomerulonephritis. She survived her acute illness only to die 2 months later of acute leukemia. This patient is a reminder that severe hemorrhagic cystitis from oral CYP still exists, and that WG can be resistant to even toxic doses of oral CYP. Alternative therapies are discussed.     

Hepatic infarction associated with terminal hemorrhagic necrotizing enteropathy (THNE): case report.

A case of hepatic infarction associated with terminal hemorrhagic necrotizing enteropathy (THNE) in an 84-year-old woman with cardiac failure is presented. The autopsy showed hepatic infarction, THNE, fibrous endocarditis, generalized arteriosclerosis, myocardial hypertrophy, liver congestion, and other findings as described. Both rare infarctions (hepatic and intestinal) seemed to have originated not only as a result of impaired systemic circulation due to cardiac failure, but also from liver congestion due to peripheral circulatory deficiency through the portal vein. The circulatory correlation between these infarcts of the liver and intestine is discussed.