Michowitz M, Noy S, Chayen D, Baratz M, Bawnik J B
Department of Surgery, Tel Aviv Medical Center, Israel.
Am Surg. 1989 Sep;55(9):566-9.
Extensive brownish discoloration of the small bowel is rare and has been described mainly in association with malabsorption disorders. It is related to deficiency of the fat soluble vitamin E. Vitamin E is an antioxidant substance that prevents peroxidation of unsaturated fatty acids. Vitamin E deficiency may result in oxidized lipids, which when polymerized with polysaccharides form the brown, PAS-positive pigment termed ceroid or lipofuscin. The deposition of pigmented granules in the effected tissues accounts for the brownish discoloration. We present three patients ultimately found to have "brown bowel syndrome (BBS)," in which the symptoms, preoperative findings, and respective diagnoses were different. In all three patients, serum Vitamin E levels were found to be extremely low.
小肠广泛的褐色变色较为罕见，主要在与吸收不良性疾病相关的情况下被描述过。它与脂溶性维生素E缺乏有关。维生素E是一种抗氧化物质，可防止不饱和脂肪酸的过氧化。维生素E缺乏可能导致脂质氧化，当脂质与多糖聚合时，会形成褐色的、过碘酸雪夫染色（PAS）阳性的色素，称为类蜡质或脂褐素。色素颗粒在受影响组织中的沉积导致了褐色变色。我们报告了三名最终被诊断为“褐色肠综合征（BBS）”的患者，他们的症状、术前检查结果及各自的诊断均有所不同。在所有三名患者中，血清维生素E水平均极低。
