Dolgin S E, Larsen J G, Shah K D, David E
Department of Surgery, City Hospital Center, Elmhurst, New York, NY.
J Pediatr Surg. 1990 Jun;25(6):696-8. doi: 10.1016/0022-3468(90)90369-k.
Serious gastrointestinal infections from cytomegalovirus (CMV) are often observed in immunosuppressed patients especially those with acquired immunodeficiency syndrome (AIDS). Hemorrhage and perforation have been frequent consequences. We present a case of CMV enteritis in an infant with AIDS who suffered massive hemorrhage and subsequent fatal small bowel obstruction from this condition. Gross findings at laparotomy were striking, diffuse, large yellowish plaques along the entire length of the small bowel. Each of these had a central ulceration. Each eventually caused a partial narrowing resulting in refractory small bowel obstruction. Biopsy of one of these lesions demonstrated many cells with typical cytomegalic inclusion bodies. This report illustrates a newly recognized type of CMV enteritis that can affect an infant and be readily recognized at laparotomy.
巨细胞病毒(CMV)引起的严重胃肠道感染常见于免疫抑制患者,尤其是获得性免疫缺陷综合征(AIDS)患者。出血和穿孔是常见后果。我们报告一例患有AIDS的婴儿发生CMV肠炎,因该病导致大量出血,随后出现致命的小肠梗阻。剖腹手术的大体所见很显著,沿小肠全长可见弥漫性、大片淡黄色斑块。每个斑块都有中央溃疡。每个斑块最终导致肠腔部分狭窄,进而引起难治性小肠梗阻。对其中一个病变进行活检显示,许多细胞含有典型的巨细胞包涵体。本报告阐述了一种新认识的CMV肠炎类型,可累及婴儿,且在剖腹手术时易于识别。