Harrington Chris, Rodgers Colin
Department of Medicine, Northern Health and Social Care Trust, Antrim, UK.
Department of Gastroenterology, Antrim Area Hospital, Antrim, UK.
BMJ Case Rep. 2014 Jul 8;2014:bcr2013203241. doi: 10.1136/bcr-2013-203241.
An underweight 15-year-old boy had a video capsule endoscopy (VCE) to investigate iron deficient anaemia associated with elevated platelet and white cell counts. The suspicion was of subclinical small bowel Crohn's disease after the findings of a radiolabelled white cell scan. The VCE in May 2007 found patchy inflammation and superficial ulcers in the terminal ileum consistent with Crohn's disease. By March 2008, the patient remained asymptomatic but the capsule had not passed. He was treated with steroids to improve the inflammation and allow the capsule to pass. This was unsuccessful. Abdominal X-rays appeared to show that it was in the rectum. CT of the abdomen and pelvis in July 2012 showed that it was actually in the mid-distal ileum within a mass of inflamed and matted small bowel loops. He was last reviewed in March 2014. He has now retained the capsule asymptomatically for 6 years and 10 months.
一名体重不足的15岁男孩接受了视频胶囊内镜检查(VCE),以调查与血小板和白细胞计数升高相关的缺铁性贫血。放射性标记白细胞扫描结果提示可能存在亚临床小肠克罗恩病。2007年5月的VCE检查发现回肠末端有斑片状炎症和浅表溃疡,符合克罗恩病表现。到2008年3月,患者仍无症状,但胶囊未排出。给予其类固醇治疗以减轻炎症并促使胶囊排出,但未成功。腹部X线片显示胶囊似乎在直肠内。2012年7月的腹部和盆腔CT显示,它实际上位于中远端回肠,处于一团发炎且相互粘连的小肠肠袢内。他最后一次接受复查是在2014年3月。目前,他已无症状地保留该胶囊6年10个月。