儿童和青少年孤立性直肠溃疡综合征。
Solitary rectal ulcer syndrome in children and adolescents.
机构信息
Department of Pediatrics, University of California, San Francisco, CA 94143-0136, USA.
出版信息
J Pediatr Gastroenterol Nutr. 2012 Feb;54(2):266-70. doi: 10.1097/MPG.0b013e318240bba5.
OBJECTIVES
The aim of this study was to describe the presenting symptoms, endoscopic and histologic findings, and clinical courses of pediatric patients diagnosed with solitary rectal ulcer syndrome (SRUS).
METHODS
We describe 15 cases of SRUS diagnosed at our institution during a 13-year period. Cases were identified by review of a pathology database and chart review and confirmed by review of biopsies. Data were collected by retrospective chart review.
RESULTS
Presenting symptoms were consistent but nonspecific, most commonly including blood in stools, diarrhea alternating with constipation, and abdominal/perianal pain. Fourteen of 15 patients had normal hemoglobin/hematocrit, erythrocyte sedimentation rate, and albumin at diagnosis. Endoscopic findings, all limited to the distal rectum, ranged from erythema to ulceration and polypoid lesions. Histology revealed characteristic findings. Stool softeners and mesalamine suppositories improved symptoms, but relapse was common.
CONCLUSIONS
SRUS in children presents with nonspecific symptoms and endoscopic findings. Clinical suspicion is required, and diagnosis requires histologic confirmation. Response to present treatments is variable.
目的
本研究旨在描述诊断为孤立性直肠溃疡综合征（SRUS）的儿科患者的临床表现、内镜和组织学发现以及临床病程。
方法
我们描述了 15 例在我们机构诊断的 SRUS 病例，这些病例是通过对病理数据库和图表审查进行回顾，并通过对活检的审查进行确认的。数据通过回顾性图表审查收集。
结果
临床表现一致但无特异性，最常见的症状包括粪便带血、腹泻与便秘交替以及腹部/肛周疼痛。15 例患者中有 14 例在诊断时血红蛋白/血细胞比容、红细胞沉降率和白蛋白均正常。内镜检查结果均局限于直肠远端，范围从红斑到溃疡和息肉样病变。组织学显示出特征性发现。大便软化剂和 5-氨基水杨酸栓剂改善了症状，但复发很常见。
结论
儿童的 SRUS 表现为非特异性症状和内镜发现。需要临床怀疑，诊断需要组织学确认。目前治疗的反应各不相同。
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