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良性肠积气症恶变时：系统性硬化症患者肠道穿孔的罕见病例

When the Benign Pneumatosis Intestinalis Becomes No Longer Benign: A Rare Case of Bowel Perforation in a Patient with Systemic Sclerosis.

作者信息

Guan Jian, Munaf Alvina, Simmonds Alric V, Inayat Irteza

机构信息

Department of Internal Medicine, Graduate Medical Education, Florida Hospital, 2501 N. Orange Suite 235, Orlando, FL 32804, USA.

Department of General Surgery, Graduate Medical Education, Florida Hospital, 2415 N. Orange Ave., Suite 400, Orlando, FL 32804, USA.

出版信息

Case Rep Gastrointest Med. 2018 Aug 26;2018:5124145. doi: 10.1155/2018/5124145. eCollection 2018.

DOI:10.1155/2018/5124145
PMID:30225151
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6129327/
Abstract

Systemic sclerosis is a multisystem disease featured with autoimmunity and organ fibrosis. Although gastrointestinal (GI) tract involvement is common in patients with systemic sclerosis, colonic perforation is extremely rare. Benign pneumatosis intestinalis, a phenomenon more frequently seen in rheumatologic conditions, makes the diagnosis of colonic perforation even more challenging. We report a unique case of colonic perforation in a patient with chronic systemic sclerosis. This patient initially presented with mild abdominal pain and hematemesis. Urgent upper endoscopy was unremarkable and radiology showed stable pneumatosis intestinalis. Due to worsening abdominal pain, laparotomy exploration was performed and colonic perforation with transmural ischemic necrosis was found.

摘要

系统性硬化症是一种以自身免疫和器官纤维化为特征的多系统疾病。尽管胃肠道受累在系统性硬化症患者中很常见，但结肠穿孔极为罕见。良性肠积气症是一种在风湿性疾病中更常见的现象，这使得结肠穿孔的诊断更具挑战性。我们报告了一例慢性系统性硬化症患者发生结肠穿孔的独特病例。该患者最初表现为轻度腹痛和呕血。紧急上消化道内镜检查未发现异常，影像学检查显示肠积气症稳定。由于腹痛加重，进行了剖腹探查，发现结肠穿孔并伴有透壁性缺血坏死。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/28eec085ed6e/CRIGM2018-5124145.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/0cb57e82b7fb/CRIGM2018-5124145.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/ba899e9246fa/CRIGM2018-5124145.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/15556b2ce3a7/CRIGM2018-5124145.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/28eec085ed6e/CRIGM2018-5124145.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/0cb57e82b7fb/CRIGM2018-5124145.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/ba899e9246fa/CRIGM2018-5124145.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/15556b2ce3a7/CRIGM2018-5124145.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df42/6129327/28eec085ed6e/CRIGM2018-5124145.004.jpg

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