Gallegos González L, Flores Izquierdo G, Cobos D, Jurado J, O'Farrill J B
Rev Gastroenterol Mex. 1976 Jan-Jun;41(1):1-5.
The authors present a case review of a congenital abnormality of the inferior mesenteric blood vessels which resulted in ischemia of the descending colon and rectosigmoid area. The resulting colitis is only very rarely secondary to a vascular congenital abnormality. In this case, rectosigmoidoscopy, barioum study of the large bowel and a biopsy of the rectal mucosa pointed towards the ischemic nature of the lesion. This led to the selective angiographic study of the inferior mesenteric vessels with findings of a dilated inferior mesenteric artery and angiodysplasia. Surgical treatment included tying off of the inferior mesenteric artery and resection of the descending and rectosigmoid colon followed by transverse colon-rectum anastomosis. The angiographic and histopathologic studies were of great importance in establishing the true nature of the patient's clinical syndrome. One must keep in mind that the rectosigmoidoscopic findings may be seen in other disease states which do not have a vascular origin. These include Crohn's disease, severe amoebiasis and penumatosis of the intestine.
作者介绍了一例肠系膜下血管先天性异常导致降结肠和直肠乙状结肠区域缺血的病例回顾。由此引发的结肠炎非常罕见地继发于血管先天性异常。在该病例中，直肠乙状结肠镜检查、大肠钡剂造影以及直肠黏膜活检均指向病变的缺血性质。这促使对肠系膜下血管进行选择性血管造影研究，结果发现肠系膜下动脉扩张和血管发育异常。手术治疗包括结扎肠系膜下动脉以及切除降结肠和直肠乙状结肠，随后进行横结肠 - 直肠吻合术。血管造影和组织病理学研究对于确定患者临床综合征的真实性质非常重要。必须牢记，直肠乙状结肠镜检查结果可能在其他非血管源性的疾病状态中出现。这些疾病包括克罗恩病、严重阿米巴病和肠道积气症。
