Hwang Seong-Su, Chung Woo-Chul, Lee Kang-Moon, Kim Hyun-Jin, Paik Chang-Nyol, Yang Jin-Mo
Department of Internal Medicine, St. Vincent's Hospital, The Catholic University, Gyunggi-do 442-723, Korea.
World J Gastroenterol. 2008 Apr 14;14(14):2272-6. doi: 10.3748/wjg.14.2272.
Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 41-year-old male patient, who presented with abdominal pain and bloody diarrhea. A colonoscopy showed markedly edematous mucosa with tortuous dilatation of the veins and a deep ulceration at the rectosigmoid junction. On an abdominal computed tomography (CT) scan and CT angiography, the mesenteric and splenic veins were absent with numerous venous collaterals for drainage. The patient gradually responded to oral aminosalicylate therapy, and was in remission after nine months. In most cases, non-occlusive ischemic injury is caused by idiopathic form and occlusive ischemia is caused by abnormalities of arteries and acute venous thrombosis. However, chronic venous insufficiency due to obstruction of macrovascular mesenteric vein rarely causes ischemia of the bowel. This report describes the first case of ischemic colitis caused by obstruction of the mesenteric and splenic veins.
肠道缺血性损伤是一种众所周知的疾病实体，具有广泛的病理和临床发现。结肠血液供应的突然下降对其发展至关重要。我们遇到一名41岁男性患者，他表现为腹痛和血性腹泻。结肠镜检查显示黏膜明显水肿，静脉迂曲扩张，直肠乙状结肠交界处有深部溃疡。腹部计算机断层扫描（CT）和CT血管造影显示，肠系膜静脉和脾静脉缺如，有大量用于引流的静脉侧支。患者对口服氨基水杨酸治疗逐渐产生反应，9个月后病情缓解。在大多数情况下，非闭塞性缺血性损伤由特发性形式引起，闭塞性缺血由动脉异常和急性静脉血栓形成引起。然而，由于大血管肠系膜静脉阻塞导致的慢性静脉功能不全很少引起肠道缺血。本报告描述了首例由肠系膜静脉和脾静脉阻塞引起的缺血性结肠炎病例。
