Tsujikawa Tomoyuki, Nezu Riichiro, Andoh Akira, Saotome Takao, Araki Yoshio, Ishizuka Yoshiyuki, Sasaki Masaya, Koyama Shigeki, Fujiyama Yoshihide
Division of Gastroenterology, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Japan.
J Gastroenterol. 2004;39(3):284-7. doi: 10.1007/s00535-003-1290-9.
Acute lower gastrointestinal bleeding is a rare complication of Crohn's disease (CD). Although anti-tumor necrosis factor-alpha (TNF-alpha, infliximab) therapy has been established for patients with inflammatory and fistulous CD, there has been little evidence on whether infliximab is effective for the hemorrhagic type of CD. We report a case of a 31-year-old man with CD who had recurrent sudden-onset bloody stool. After a second surgery, he visited our hospital because of bloody stool. Infusion of infliximab stopped the bleeding and promoted the healing of ulcers in the ileum and ileocolon anastomosis. We suggest that infliximab therapy should be tried to stop acute gastrointestinal bleeding in CD before there is a surgical emergency.
急性下消化道出血是克罗恩病（CD）的一种罕见并发症。尽管抗肿瘤坏死因子-α（TNF-α，英夫利昔单抗）疗法已被确立用于治疗炎症性和瘘管性CD患者，但关于英夫利昔单抗对出血型CD是否有效，几乎没有证据。我们报告一例31岁患有CD的男性患者，该患者反复突发便血。二次手术后，他因便血前来我院就诊。输注英夫利昔单抗止住了出血，并促进了回肠和回结肠吻合口溃疡的愈合。我们建议，在出现外科急症之前，应尝试使用英夫利昔单抗疗法来止住CD患者的急性胃肠道出血。
