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儿童弥漫性结直肠血管发育异常术前误诊为溃疡性结肠炎:一例报告

Diffuse colorectal angiodysplasia misdiagnosed preoperatively as ulcerative colitis in a child: report of a case.

作者信息

Ozer Ilter, Birol Bostanci E, Ozogul Yusuf B, Ulker Aysel, Temucin Tulay, Akoglu Musa

机构信息

Department of Gastrointestinal Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Demirlibahce Mah., Doganbahcesi Sok. 6/3, 06340, Mamak, Ankara, Turkey.

出版信息

Surg Today. 2008;38(8):731-3. doi: 10.1007/s00595-007-3698-y. Epub 2008 Jul 31.

Abstract

Angiodysplasia is primarily a disease of the elderly, and it is rarely encountered in the pediatric population. We report a case of diffuse colorectal angiodysplasia, diagnosed postoperatively in a 13-year-old boy who underwent hand-assisted laparoscopic total proctocolectomy and ileal pouch anal anastomosis (IPAA) for assumed corticosteroid-resistant ulcerative colitis. The findings of preoperative repeated colonoscopies and biopsies had been consistent with active colitis. Distinguishing ulcerative colitis from angiodysplasia is not usually difficult in patients with rectal bleeding. To our knowledge, this is the fi rst case report of such a challenging diagnostic problem.

摘要

血管发育异常主要是一种老年疾病,在儿科人群中很少见。我们报告一例弥漫性结直肠血管发育异常病例,该病例是在一名13岁男孩接受手辅助腹腔镜全直肠结肠切除术和回肠储袋肛管吻合术(IPAA)后诊断出来的,该男孩因疑似皮质类固醇抵抗性溃疡性结肠炎而接受手术。术前多次结肠镜检查和活检结果与活动性结肠炎一致。对于直肠出血患者,区分溃疡性结肠炎和血管发育异常通常并不困难。据我们所知,这是此类具有挑战性诊断问题的首例病例报告。

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