Saito Hironobu, Kobayashi Hiroko, Watanabe Kenya, Saito Keietsu, Rai Tsuyoshi, Sasajima Tomomi, Orikasa Hiroshi, Saka Mitsuru, Hoshino Yutaka, Terashima Shinya, Gotoh Mitsukazu, Obara Katsutoshi, Ohira Hiromasa
Department of Internal Medicine II, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.
Fukushima J Med Sci. 2008 Jun;54(1):38-42. doi: 10.5387/fms.54.38.
A 19-year-old Japanese woman had melena 2 months after systemic lupus erythematosus was diagnosed. Colonoscopy showed diffuse ulceration with bleeding in the ileum, suggesting that the melena was due to ischemic enteritis associated with lupus enteritis. Because treatment with high doses of steroid, anticoagulants, and cyclophosphamide pulse was ineffective, surgical intervention was planned. On exploration, it was impossible to determine the extent of resection visually. Intraoperative esophagogastroduodenoscopy clearly revealed the border between the ulcer and normal area, permitting successful resection of the ileum and ileostomy. This is the first report to document the usefulness of esophagogastroduodenoscopy in surgical treatment of ischemic enteritis in a patient with systemic lupus erythematosus.
一名19岁的日本女性在系统性红斑狼疮确诊2个月后出现黑便。结肠镜检查显示回肠弥漫性溃疡伴出血，提示黑便是由与狼疮性肠炎相关的缺血性肠炎所致。由于大剂量类固醇、抗凝剂和环磷酰胺脉冲治疗无效，遂计划进行手术干预。术中探查时，肉眼无法确定切除范围。术中食管胃十二指肠镜检查清楚地显示了溃疡与正常区域的边界，从而成功切除回肠并进行了回肠造口术。这是第一份记录食管胃十二指肠镜检查在系统性红斑狼疮患者缺血性肠炎手术治疗中有用性的报告。
