Kristinsson Jón O, Hopman Wim P M, Oyen Wim J G, Drenth Joost P H
Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.
BMC Gastroenterol. 2007 Mar 21;7:11. doi: 10.1186/1471-230X-7-11.
Few studies have described patients with foregut dysmotility in inflammatory bowel disease. The aim of this case series was to evaluate clinical characteristics of 5 patients with inflammatory bowel disease and symptoms and signs of upper gut dysmotility.
We describe a series of four patients with Crohn's disease and one with indeterminate colitis who presented with severe symptoms and signs of gastroparesis. We reviewed medical records of all cases. Gastric emptying of a solid meal was assessed by scintigraphy. Small bowel enteroclysis, gastroduodenoscopy and colonoscopy with biopsies were performed to estimate the activity of the disease and to exclude organic obstruction. None of the patients had any signs of active inflammation or stricture. All of the patients had markedly delayed gastric emptying with a mean t 1/2 of 234 minutes (range 110-380 minutes; normal values 54-94 minutes).
Clinicians should consider impaired gastric emptying when evaluating patients with Crohn's disease and severe symptoms of upper gut dysmotility, which cannot be attributed to active inflammation or organic obstruction of the digestive tract. Symptoms in these patients are refractory to various therapeutic interventions including tube feeding and gastric surgery.
很少有研究描述炎症性肠病中存在前肠动力障碍的患者。本病例系列的目的是评估5例炎症性肠病患者以及上消化道动力障碍的症状和体征的临床特征。
我们描述了一系列4例克罗恩病患者和1例不确定性结肠炎患者，他们表现出严重的胃轻瘫症状和体征。我们回顾了所有病例的病历。通过闪烁扫描评估固体餐的胃排空情况。进行小肠灌肠、胃十二指肠镜检查和结肠镜检查及活检，以评估疾病的活动度并排除器质性梗阻。所有患者均无任何活动性炎症或狭窄的迹象。所有患者的胃排空均明显延迟，平均t1/2为234分钟（范围110 - 380分钟；正常值54 - 94分钟）。
临床医生在评估克罗恩病患者以及出现不能归因于消化道活动性炎症或器质性梗阻的严重上消化道动力障碍症状的患者时，应考虑胃排空受损的情况。这些患者的症状对包括管饲和胃手术在内的各种治疗干预均无效。
