Munzer D, Eyad C
Mouassat University Hospital, Damascus-Syria.
Trop Gastroenterol. 1992 Jan-Mar;13(1):27-35.
Spastic Colitis (SC) of the fifties has been deleted and included in the Irritable Bowel Syndrome, as inflammation is not present, and the disturbed intestinal motility may involve the small and large intestine. With the advent of colonoscopy, we could investigate this generalized common term. Between 1983 and 1988 we have studied 120 documented cases of SC by colonoscopy with multiple biopsies. In every patient, we relied on consecutive procedures to confirm the diagnosis. They included: Stool examination, barium enema, small bowels series, colonoscopy with multiple biopsies. Serological diagnosis of Amebiasis has been applied to 41 patients only. With a normal small bowels, barium enema revealed a severe spasm of the whole colon, or a segmental spasm in one part of the colon. In 53 cases (44%,) we have noted virtual absence of haustra in the tubular descending colon. Colonoscopy in all cases has revealed an active contraction with some congestion of the mucosa or hyperemia. Different degrees of inflammatory reaction shown on multiple biopsies make the diagnosis of SC in these cases more relevant. In the Afro-Asiatic countries where amebiasis is endemic, SC is to be considered, as colonoscopy is proving the prevalence of congested or inflammatory process in the colonic mucosa, even when stool examination is repeatedly negative for amebiasis.
五十年代的痉挛性结肠炎（SC）已被删除，并纳入肠易激综合征，因为不存在炎症，且肠道运动紊乱可能累及小肠和大肠。随着结肠镜检查的出现，我们可以对这个广义的通用术语进行研究。1983年至1988年间，我们通过结肠镜检查和多次活检研究了120例有记录的SC病例。对每位患者，我们依靠连续的检查程序来确诊。这些检查包括：粪便检查、钡灌肠、小肠造影、结肠镜检查及多次活检。仅对41例患者进行了阿米巴病的血清学诊断。小肠正常时，钡灌肠显示整个结肠严重痉挛，或结肠某一部分节段性痉挛。在53例（44%）病例中，我们注意到降结肠呈管状，几乎没有袋状结构。所有病例的结肠镜检查均显示有活跃收缩，伴有黏膜充血或发红。多次活检显示的不同程度炎症反应使这些病例中SC的诊断更具相关性。在阿米巴病流行的亚非国家，应考虑SC，因为结肠镜检查证明结肠黏膜存在充血或炎症过程，即使粪便检查多次未发现阿米巴病。
