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结肠弥漫性毛细血管扩张症:一例报告。

Diffuse telangiectasia of the colon: A case report.

作者信息

Li Jun-An, Zhong Li-Li, Li Bo, Jiang Dong-Qiang, Zhao Yin-Long

机构信息

Gastroenterology and Center of Digestive Endoscopy.

Jilin Provincial Key Laboratory on Molecular and Chemical Genetic.

出版信息

Medicine (Baltimore). 2020 Aug 21;99(34):e21106. doi: 10.1097/MD.0000000000021106.

Abstract

RATIONALE

Colonic telangiectasia, also known as colonic angiodysplasia, refers to arteriovenous malformations that occur in the colon, which are common vascular lesions in the GI tract.

PATIENT CONCERNS

We report a patient, who was admitted to our hospital for colonoscopy.

DIAGNOSES

Under a microscope, all the segments of the whole colon and the varicose veins showed multiple flaky spider-like telangiectasia changes. The blood vessels were radially distributed and converged in the center. The largest blood vessel was about 10 mm in diameter and had a smooth surface with no ulcers, erosion, or bleeding.

INTERVENTIONS

It was recommended that the patient undergo a capsule endoscopy to examine small intestine.

OUTCOMES

The patient did not agree to endoscopy for personal reasons. During the follow-up half a year later, the patient had no melena with normal range of hemoglobin and red blood cell counts. The fecal occult blood test came out negative.

LESSONS

While the etiology of colonic telangiectasia remains unclear, it is common in the elderly, and is more associated with geriatric conditions and diseases, especially atherosclerotic diseases. Patients who are diagnosed with colonic telangiectasia but are asymptomatic, do not need further treatment. It is usually recommended to monitor the color of stool and check the hemoglobin and fecal occult blood regularly. Colonoscopy is the main method of diagnosis of colonic telangiectasia, and the positive rate is greater than 90%. This procedure should be performed when there is no bleeding or a small amount of bleeding.

摘要

原理

结肠毛细血管扩张症,也称为结肠血管发育异常,是指发生在结肠的动静脉畸形,是胃肠道常见的血管病变。

患者情况

我们报告一名因结肠镜检查入院的患者。

诊断

在显微镜下,整个结肠的所有节段及曲张静脉均呈现多处片状蜘蛛样毛细血管扩张改变。血管呈放射状分布并向中心汇聚。最大的血管直径约10毫米,表面光滑,无溃疡、糜烂或出血。

干预措施

建议患者接受胶囊内镜检查小肠。

结果

患者因个人原因不同意行内镜检查。半年后随访期间,患者无黑便,血红蛋白及红细胞计数在正常范围。粪便潜血试验呈阴性。

经验教训

虽然结肠毛细血管扩张症的病因尚不清楚,但在老年人中常见,且更多与老年疾病相关,尤其是动脉粥样硬化疾病。诊断为结肠毛细血管扩张症但无症状的患者无需进一步治疗。通常建议监测大便颜色并定期检查血红蛋白和粪便潜血。结肠镜检查是诊断结肠毛细血管扩张症的主要方法,阳性率大于90%。在无出血或少量出血时应进行此项检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eeea/7447499/6792532f95d9/medi-99-e21106-g001.jpg

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