Witteman B J, Weterman I T, Griffioen G, Lamers C B
Academisch Ziekenhuis, afd. Maag-, Darm- en Leverziekten, Leiden.
Ned Tijdschr Geneeskd. 1991 Apr 27;135(17):766-9.
Crohn's disease is a chronic inflammatory granulomatous disorder affecting any part of the gastrointestinal tract, particularly the terminal ileum and the colon. Familiar complications are strictures, fistulae, perforation, haemorrhages and malabsorption due to multiple resections. A patient with two rare complications of Crohn's disease is described. A 16-year-old female with ileocaecal Crohn's disease presented with anaemia and ileus. This ileus was caused by some 40 tablets of ferrosulphate with a non-soluble matrix, in the presence of an existing stenosis of the ileum due to Crohn's disease. An ileocaecal resection was performed. During an exacerbation of Crohn's disease she developed hepatic vein thrombosis with a Budd-Chiari syndrome (upper abdominal pain, hepatomegaly and ascites). Prescription of tablets with a non-soluble matrix is contraindicated in patients with a partial stenosis of the intestine. Patients with active Crohn's disease are predisposed to thromboembolic complications. Hepatic vein thrombosis in our patient may have been the result of hypercoagulability during the exacerbation of her disease.
克罗恩病是一种慢性炎症性肉芽肿性疾病，可累及胃肠道的任何部位，尤其是回肠末端和结肠。常见并发症包括狭窄、瘘管、穿孔、出血以及因多次切除导致的吸收不良。本文描述了一名患有克罗恩病两种罕见并发症的患者。一名16岁患有回盲部克罗恩病的女性患者出现贫血和肠梗阻。此次肠梗阻是由约40片含不溶性基质的硫酸亚铁片引起的，当时患者因克罗恩病已存在回肠狭窄。遂进行了回盲部切除术。在克罗恩病病情加重期间，她出现了肝静脉血栓形成并伴有布加综合征（上腹部疼痛、肝肿大和腹水）。肠道部分狭窄的患者禁用含不溶性基质的片剂。活动性克罗恩病患者易发生血栓栓塞并发症。我们这位患者的肝静脉血栓形成可能是其疾病加重期间高凝状态的结果。
