Wang Zhonggao, Yu Henxi, Gu Yongquan, Li Jianxin, Zhang Jian, Li Zhen
Vascular Institute and Xuan Wu Hospital, Capital University of Medical Science, Beijing, China.
Int J Angiol. 2007 Winter;16(4):149-50. doi: 10.1055/s-0031-1278271.
Chronic ischemia produces corresponding tissue hypoplasia. However, the present paper reports a distinctive hypertrophy of the intestine due to chronic mesenteric artery insufficiency. Two patients with chronic mesentery artery insufficiency confirmed by angiography are presented. The first patient demonstrated marked hypertrophy of the intestine, while the second patient was remarkable for pronounced hypoplasia. During the surgery of the first patient, an ileum approximately 60 cm long with a sausage-like consistency and cyanosis was identified proximal to the cecum; wall-attached thromboembolism material and the hypertrophic segment of ileum were removed. In the other patient, the intestine wall was paper thin; after the aortomesenteric bypass, the intestine wall grew thicker. Postoperative recovery of both patients was uneventful. The commonly observed situation after a longstanding hypoxic insult in a setting of chronic mesenteric ischemia is that the target tissue will, at least, develop slight hypoplasia. However, the cases presented here had either pronounced hyperplasia or severe hypoplasia. The authors find this observation so interesting that they report it in the hope that an explanation for this conundrum may come forth.
慢性缺血会导致相应组织发育不全。然而，本文报道了一例因慢性肠系膜动脉供血不足导致的肠道显著肥大。文中介绍了两名经血管造影证实患有慢性肠系膜动脉供血不足的患者。第一名患者表现出明显的肠道肥大，而第二名患者则以显著的发育不全为特征。在第一名患者的手术过程中，在盲肠近端发现一段约60厘米长、呈香肠样质地且发绀的回肠；切除了附着在肠壁上的血栓栓塞物质和回肠肥大段。在另一名患者中，肠壁薄如纸张；在进行主动脉肠系膜旁路手术后，肠壁变厚。两名患者术后恢复均顺利。在慢性肠系膜缺血的长期缺氧损伤后，常见的情况是靶组织至少会出现轻微发育不全。然而，这里呈现的病例要么有明显的增生，要么有严重的发育不全。作者认为这一观察结果非常有趣，因此进行报道，希望能找到对此难题的解释。
