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[病毒相关性出血性结肠炎在急性直肠出血鉴别诊断中的应用]

[Virus-associated hemorrhagic colitis in the differential diagnosis of peracute rectal bleeding].

作者信息

Tschöpe D, Niederau C, Erckenbrecht J, Günther B, Frenzel H, Strohmeyer G

机构信息

Klinische Abteilung des Diabetesforschungsinsititutes, Universität Düsseldorf.

出版信息

Dtsch Med Wochenschr. 1989 Jan 13;114(2):58-61. doi: 10.1055/s-2008-1066552.

Abstract

Severe anal bleeding together with increasing abdominal discomfort occurred in an 81-year-old woman previously hospitalized numerous times because of decompensated type II B diabetes. A suspected rectal cancer was excluded by biopsy from the lower to middle rectum, but the biopsy revealed histologically indurated and bleeding ulcerations. Typical nuclear inclusion bodies provided the diagnosis of virus-associated proctocolitis. Serological tests supported the diagnosis of infection with herpes simplex and cytomegalic virus. Laser coagulation stopped the bleeding. At the same time a Guillain-Barré syndrome was noted which improved after administration of cortisone and high parenteral doses of acyclovir.

摘要

一名81岁女性出现严重的肛门出血并伴有腹部不适加重,该女性此前因II型B期失代偿性糖尿病多次住院。经直肠中下段活检排除了直肠癌的可能,但活检显示组织学上有硬结和出血性溃疡。典型的核内包涵体确诊为病毒相关性直肠结肠炎。血清学检测支持单纯疱疹病毒和巨细胞病毒感染的诊断。激光凝固术止住了出血。同时发现了格林-巴利综合征,在给予皮质类固醇和高剂量肠外阿昔洛韦后病情有所改善。

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