阿米巴肝脓肿患者的回盲部肿物：病因及处理
Ileocecal masses in patients with amebic liver abscess: etiology and management.
作者信息
Misra Sri Prakash, Misra Vatsala, Dwivedi Manisha
机构信息
Department of Gastroenterology, Moti Lal Nehru Medical College, Allahabad 211 001, India.
出版信息
World J Gastroenterol. 2006 Mar 28;12(12):1933-6. doi: 10.3748/wjg.v12.i12.1933.
AIM
To assess the causes of ileocecal mass in patients with amebic liver abscess.
METHODS
Patients with amebic liver abscess and ileocecal mass were carefully examined and investigated by contrast-enhanced CT scan followed by colonoscopy and histological examination of biopsy materials from lesions during colonoscopy.
RESULTS
Ileocecal masses were found in seventeen patients with amebic liver abscess. The cause of the mass was ameboma in 14 patients, cecal tuberculosis in 2 patients and adenocarcinoma of the cecum in 1 patient. Colonic ulcers were noted in five of the six (83%) patients with active diarrhea at presentation. The ileocecal mass in all these patients was ameboma. Ulcers were seen in only one of the 11 (9%) patients without diarrhea. The difference was statistically significant from the group with diarrhea (P< 0.005).
CONCLUSION
Ileocecal mass is not an uncommon finding in patients with amebic liver abscess. Although, the ileocecal mass is due to ameboma formation in most cases, it should not be assumed that this is the case in all patients. Colonoscopy and histological examination of the target biopsies are mandatory to avoid missing a more sinister lesion.
目的
评估阿米巴肝脓肿患者回盲部肿块的病因。
方法
对患有阿米巴肝脓肿和回盲部肿块的患者进行仔细检查，并通过增强CT扫描、随后的结肠镜检查以及结肠镜检查期间对病变活检材料进行组织学检查来进行调查。
结果
在17例阿米巴肝脓肿患者中发现了回盲部肿块。肿块的病因在14例患者中为阿米巴瘤，2例为盲肠结核，1例为盲肠腺癌。在出现活动性腹泻的6例患者中的5例（83%）中发现了结肠溃疡。所有这些患者的回盲部肿块均为阿米巴瘤。在11例（9%）无腹泻的患者中仅1例出现溃疡。与腹泻组相比，差异具有统计学意义（P<0.005）。
结论
回盲部肿块在阿米巴肝脓肿患者中并非罕见发现。虽然在大多数情况下，回盲部肿块是由于阿米巴瘤形成，但不应认为所有患者都是如此。必须进行结肠镜检查和对目标活检进行组织学检查，以避免漏诊更严重的病变。
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