Katon R M, Brendler S J, Ireland K
Department of Medicine, Oregon Health Sciences University, Portland 97201.
J Clin Gastroenterol. 1989 Oct;11(5):555-60. doi: 10.1097/00004836-198910000-00013.
A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia. Radiographic evaluation of the colon showed segmental strictures which were interpreted as Crohn's disease. Medical treatment was not helpful. Neither gross endoscopic appearance nor multiple biopsies of the esophagus, stomach, and colon were diagnostic. Finally, laparotomy with full-thickness biopsies of the stomach and colon revealed linitis plastica. The clinician should be alert to colonic metastases from gastric linitis plastica, for it can produce focal or segmental strictures, mimicking more common colonic diseases such as Crohn's disease. A full-thickness biopsy is often necessary for a firm diagnosis. We review the literature on this occurrence, highlighting the clinical and radiologic spectrum, as well as the organ systems most often affected when gastric linitis plastica metastasizes.
一名60岁女性出现进行性下腹部疼痛、非血性腹泻和体重减轻，随后出现严重上腹部疼痛和吞咽困难。结肠的影像学评估显示节段性狭窄，诊断为克罗恩病。药物治疗无效。食管、胃和结肠的大体内镜表现及多次活检均未明确诊断。最后，剖腹手术并对胃和结肠进行全层活检，结果显示为皮革胃。临床医生应警惕皮革胃的结肠转移，因为它可产生局灶性或节段性狭窄，酷似克罗恩病等更常见的结肠疾病。通常需要进行全层活检才能明确诊断。我们回顾了关于这种情况的文献，重点介绍了临床和放射学表现范围，以及皮革胃转移时最常受累的器官系统。
