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无菌性脓肿和炎症性肠病:两例病例并文献复习。

Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature.

机构信息

Division of Gastroenterology, Women's College Hospital, Toronto, ON, Canada.

Division of Gastroenterology, St. Michael's Hospital, Toronto, ON, Canada.

出版信息

Can J Gastroenterol Hepatol. 2017;2017:5124354. doi: 10.1155/2017/5124354. Epub 2017 Feb 6.

Abstract

. Aseptic abscesses (AA) are sterile lesions that represent an extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). Though Canada has the highest prevalence of IBD in the world, reports of IBD-associated AA are absent in Canada. This may represent a different IBD phenotype or underrecognition and underreporting. . To explore AA as a possible EIM of IBD and evaluate clinical and investigative findings among patients with IBD-associated AA. . Retrospective chart and literature reviews were performed to find cases of IBD-associated AA at our institution and in the literature. . We identified 2 cases of IBD-associated AA in our institution. Both patients had ulcerative colitis and presented with fever, abdominal pain, and weight loss. Radiological workup and aspiration showed sterile splenic abscesses. The AA were unresponsive to antibiotics. One patient improved on corticosteroids and one underwent splenectomy. We retrieved 37 cases of IBD-associated AA from the literature. All patients showed no evidence of infection, failed to resolve with antibiotics, and, if attempted, improved on corticosteroids. . Our cases are the first reported in Canada. They support literature which suggests AA as an EIM of IBD and may help increase recognition and reporting of this phenomenon.

摘要

无菌性脓肿(AA)是无菌性病变,代表炎症性肠病(IBD)的肠外表现(EIM)。尽管加拿大是世界上 IBD 患病率最高的国家,但加拿大却没有 IBD 相关 AA 的报告。这可能代表了一种不同的 IBD 表型或认识不足和漏报。

探讨 AA 作为 IBD 的一种可能的 EIM,并评估 IBD 相关 AA 患者的临床和调查结果。

我们对我院和文献中的 IBD 相关 AA 病例进行了回顾性图表和文献复习。

我们在我院发现了 2 例 IBD 相关 AA 的病例。这两名患者均患有溃疡性结肠炎,表现为发热、腹痛和体重减轻。影像学检查和抽吸显示无菌性脾脓肿。AA 对抗生素无反应。一名患者接受皮质类固醇治疗后有所改善,一名患者接受了脾切除术。我们从文献中检索到 37 例 IBD 相关 AA 的病例。所有患者均无感染证据,抗生素治疗无效,如尝试使用皮质类固醇则有所改善。

我们的病例是加拿大首例报告。它们支持文献表明 AA 是 IBD 的一种 EIM,并可能有助于提高对这种现象的认识和报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83e1/5317120/894a29fe4bc9/CJGH2017-5124354.001.jpg

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