Issekutz Akos, Belágyi Tibor, Rácz István, Oláh Attila
Petz Aladár Megyei Oktató Kórház, Sebészeti Osztály, H-9002 Gyór.
Magy Seb. 2003 Aug;56(3-4):120-2.
A 79-year-old female patient with rheumatoid arthritis treated with NSAIDs on long-term developed iron-deficiency anaemia and subsequently subacute intestinal obstruction. Barium enema showed multiple diaphragm-like strictures. At colonoscopy the lumen of the ascending colon was divided into compartments by multiple thin circumferential mucosal membranes. Right hemicolectomy was carried out. The histology of the resected specimen confirmed diaphragm disease of the large bowel. Diagnosis is usually difficult, even at laparotomy, due to the poor external presence of the disease. Such lesions are rare (about 10 cases have been reported in the world literature) and are similar to those previously described in the small bowel. With the increasing world-wide use of NSAIDs, clinicians must be aware of this rare gastrointestinal complication, which may require emergency surgical intervention.
一名79岁类风湿性关节炎女性患者长期服用非甾体抗炎药,出现缺铁性贫血,随后发生亚急性肠梗阻。钡剂灌肠显示多处膈膜样狭窄。结肠镜检查时,升结肠腔被多个薄的环形黏膜分隔成多个腔室。进行了右半结肠切除术。切除标本的组织学检查证实为大肠膈膜病。即使在剖腹手术时,由于该病外在表现不明显,诊断通常也很困难。此类病变罕见(世界文献报道约10例),与先前在小肠中描述的病变相似。随着非甾体抗炎药在全球范围内的使用增加,临床医生必须意识到这种罕见的胃肠道并发症,可能需要紧急手术干预。