[双氯芬酸所致的结肠膈膜样狭窄]
[Diaphragm-like strictures of the colon from diclofenac].
作者信息
Benoit R, Grobost O, Crepeau T
机构信息
Service de Médecine Interne à Orientation Gastroentérologique, Centre hospitalier de Montluçon, 18, avenue du 8 Mai 1945, F03109 Montluçon.
出版信息
Presse Med. 2001 Jun 30;30(22):1102-4.
BACKGROUND
Diaphragm-like strictures of the colon induced by nonsteroidal antiinflammatory drugs (NSAID) constitute a recently described uncommon clinical entity.
CASE REPORT
An 86-year-old man consulted for abdominal pain and constipation. The physical examination revealed bloody stools and anemia in a patient on long-standing diclofenac therapy. Colonoscopy demonstrated two diaphragm-like strictures of the left and transverse colon with ulceration of the apex. Clinical outcome was favorable after discontinuing the NSAID.
DISCUSSION
We compared this observation with 26 other case reports in the literature. The etiological mechanism appears to be related to systemic and local toxicity. Severe stenotic stricture may require surgical management. Endoscopic pneumatic dilatation may be an alternative to surgery.
背景
非甾体类抗炎药（NSAID）所致的结肠膈样狭窄是一种最近才被描述的罕见临床病症。
病例报告
一名86岁男性因腹痛和便秘前来就诊。体格检查发现该长期服用双氯芬酸的患者有便血和贫血症状。结肠镜检查显示左半结肠和横结肠有两处膈样狭窄，顶端有溃疡。停用非甾体类抗炎药后临床结果良好。
讨论
我们将该病例与文献中其他26例病例报告进行了比较。病因机制似乎与全身和局部毒性有关。严重的狭窄性狭窄可能需要手术治疗。内镜下气囊扩张术可能是手术的替代方法。
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