Taylor S F, Sondheimer J M, Sokol R J, Silverman A, Wilson H L
Department of Pediatrics, University of Colorado School of Medicine, Denver.
J Pediatr. 1991 Jul;119(1 Pt 1):24-8. doi: 10.1016/s0022-3476(05)81033-9.
We describe noninfectious bloody diarrhea in 13 of 16 infants referred for management of short bowel syndrome and parenteral nutrition during a 33-month period. The condition was characterized by bloody, watery stools associated with carbohydrate malabsorption. Colitis occurred at a mean age of 4.2 months during periods of advancing enteral feedings of a hydrolyzed protein- or amino acid-containing formula. Sigmoidoscopy performed in nine patients revealed edema, patchy erythema, loss of normal vascular pattern, and mucosal friability without ulcerations or pseudomembranes. Colonic biopsy specimens demonstrated edema and mixed hypercellularity of the lamina propria, with prominent eosinophilia. Rectal bleeding ceased if formula feedings were decreased or withheld. Of multiple medications administered, sulfasalazine seemed to improve rectal bleeding most effectively in our patients and allowed for more rapid reintroduction of enteral feedings.
在33个月的时间里，我们对16名因短肠综合征和肠外营养而接受治疗的婴儿中的13名进行了非感染性血性腹泻的描述。该病的特征为血性水样便，并伴有碳水化合物吸收不良。结肠炎发生在平均年龄4.2个月时，处于逐渐增加含水解蛋白或氨基酸配方奶肠内喂养期间。对9名患者进行的乙状结肠镜检查显示有水肿、散在红斑、正常血管形态消失以及黏膜脆性增加，但无溃疡或假膜形成。结肠活检标本显示固有层水肿和混合性细胞增多，伴有明显嗜酸性粒细胞增多。如果减少或停止配方奶喂养，直肠出血就会停止。在使用的多种药物中，柳氮磺胺吡啶似乎对我们的患者直肠出血改善最为有效，并能使肠内喂养更快重新开始。
