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戊二醛诱导的结肠炎:病例报告及文献复习。

Glutaraldehyde-induced colitis: case reports and literature review.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

出版信息

Kaohsiung J Med Sci. 2011 Dec;27(12):577-80. doi: 10.1016/j.kjms.2011.06.036. Epub 2011 Nov 27.

Abstract

Glutaraldehyde-induced colitis is an uncommon colitis in clinical practice. Because the involvement of colonic segment is determined by the endoscopic part where glutaraldehyde remains, a recent history of endoscopy and a demarcated involvement of colonic segment are the most characteristic signs of glutaraldehyde-induced colitis. The typical clinical scenario is acute onset of lower abdominal pain, fever, and bloody stool. Laboratory data usually show leukocytosis and elevated C-reactive protein. The endoscopic pictures of involved segments are compatible with acute colitis, including hyperemic, edematous, with or without multiple erosions. Acute ischemic colitis and infectious colitis should be differentiated at the outset of the disease. Stool pathogen tests are usually negative. Parenteral empiric antibiotic may be considered if severe transmural edema of the involved segment is observed in computed tomography. Conservative treatment, including bowel rest and parenteral hydration, is able to stabilize the condition in a week. Herein, we present two cases of acute proctocolitis caused by glutaraldehyde after uneventful colonoscopy.

摘要

戊二醛相关性结肠炎在临床实践中较为少见。由于结肠受累节段取决于戊二醛残留的内镜部位,因此近期内镜检查史和结肠节段的局限性受累是戊二醛相关性结肠炎的最特征性表现。典型的临床特征为下腹痛、发热和血便急性发作。实验室数据通常显示白细胞增多和 C 反应蛋白升高。受累节段的内镜图像与急性结肠炎一致,包括充血、水肿,伴有或不伴有多个糜烂。在疾病初始阶段应与急性缺血性结肠炎和感染性结肠炎相鉴别。粪便病原体检查通常为阴性。如果 CT 观察到受累节段有严重的全层水肿,可考虑给予经验性肠外抗生素治疗。包括肠道休息和肠外补液的保守治疗能够在一周内稳定病情。本文报道了 2 例结肠镜检查后无并发症的急性直肠结肠炎。

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