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[一例需与小肠肿瘤相鉴别的嗜酸性粒细胞性肠炎病例]

[A Case of Eosinophilic Enteritis Needed to Distinguish from a Tumor of the Small Intestine].

作者信息

Tsujio Gen, Aomatsu Naoki, Wang En, Yamakoshi Yoshihito, Nagashima Daisuke, Hirakawa Toshiki, Iwauchi Takehiko, Nishii Takafumi, Morimoto Junya, Nakazawa Kazunori, Tei Seika, Uchima Yasutake, Takeuchi Kazuhiro

机构信息

Dept. of Surgery, Fuchu Hospital.

出版信息

Gan To Kagaku Ryoho. 2016 Nov;43(12):1863-1865.

Abstract

A 75-year-old woman was diagnosed with aplastic anemia 6 months ago and was under follow-up at our hospital. She had originallypresented to our hospital because of ongoing diarrhea and abdominal pain. Her blood tests showed a rise in inflammatorymarkers (WBC count was 6,900/mL[eosinophil was 1.3%]and CRP was 8.60mg/dL). Her abdominal computed tomography(CT)scan showed gastric wall and small intestine edema as well as ascites. There was no evidence of free air. We diagnosed her with generalized peritonitis and performed an emergencyoperation . Intra-operatively, moderate amounts of yellowish ascitic fluid were noted, as was a diffuse reddening of the small intestine. We performed a partial resection of the small intestine. Histopathological examination showed transmural infiltration of inflammatorycells mainly comprising eosinophilic leukocytes. Eosinophils were also present in the ascitic fluid. Post-operative blood tests confirmed eosinophilic, and we diagnosed her with eosinophilic enteritis. She was started on corticosteroids and her symptoms improved immediately. We report a rare case of eosinophilic enteritis with a review of the pertinent literature.

摘要

一名75岁女性6个月前被诊断为再生障碍性贫血,一直在我院接受随访。她最初因持续腹泻和腹痛前来我院就诊。血液检查显示炎症指标升高(白细胞计数为6900/mL[嗜酸性粒细胞为1.3%],C反应蛋白为8.60mg/dL)。腹部计算机断层扫描(CT)显示胃壁和小肠水肿以及腹水。没有游离气体的迹象。我们诊断她为弥漫性腹膜炎并进行了急诊手术。术中发现中等量淡黄色腹水,小肠弥漫性发红。我们进行了小肠部分切除术。组织病理学检查显示炎症细胞全层浸润,主要为嗜酸性粒细胞。腹水中也有嗜酸性粒细胞。术后血液检查证实有嗜酸性粒细胞增多,我们诊断她为嗜酸性肠炎。她开始使用皮质类固醇治疗,症状立即改善。我们报告一例罕见的嗜酸性肠炎病例,并对相关文献进行综述。

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