Jonas G, Mahoney A, Murray J, Gertler S
Department of Medicine, University of California, Irvine.
Gastroenterology. 1988 Nov;95(5):1403-8. doi: 10.1016/0016-5085(88)90380-0.
A unique form of colitis was observed during endoscopy of the lower gastrointestinal tract in 21 patients. The patients were prepared using either tap-water enemas or standard lavage solutions. Patients were found to have discrete or confluent white plaques adherent to the colonic mucosa, mild to severe erythema of the surrounding mucosa, and variable amounts of foamy liquid upon withdrawal of the endoscope. Stool assays for Clostridium difficile toxin and bacterial cultures were negative. Mucosal biopsies revealed vacuolar changes in the lamina propria, with slight to moderate vascular congestion and foci of intramucosal hemorrhage. Five patients developed rectal bleeding, tenesmus, and increased frequency of stools, lasting up to 12 days. We believe these cases were due to contamination of the endoscope's air-water channel with solutions used during endoscope cleaning. Recognition of this entity is important, as it is preventable and may mimic pseudomembranous colitis.
在对21例患者进行下消化道内镜检查时，观察到一种独特形式的结肠炎。患者使用自来水灌肠或标准灌洗溶液进行肠道准备。发现患者结肠黏膜上有离散或融合的白色斑块，周围黏膜有轻度至重度红斑，在内镜撤出时可见不同量的泡沫状液体。艰难梭菌毒素粪便检测和细菌培养均为阴性。黏膜活检显示固有层有空泡样改变，伴有轻度至中度血管充血和黏膜内出血灶。5例患者出现直肠出血、里急后重和大便次数增加，持续长达12天。我们认为这些病例是由于内镜清洗过程中使用的溶液污染了内镜的气水通道所致。认识到这种情况很重要，因为它是可预防的，且可能类似伪膜性结肠炎。
