Bernstein L, Joseph R, Staas W E
Arch Phys Med Rehabil. 1986 Mar;67(3):194-5. doi: 10.1016/0003-9993(86)90086-9.
Bleeding from the lower gastrointestinal tract is rarely reported in spinal cord injured patients. A case is reported of such bleeding in a quadriplegic man with a solitary colonic ulcer diagnosed by flexible sigmoidoscopy and biopsy. The diagnosis of solitary colonic ulcers is difficult to make in spinal cord injured persons because presenting features may be masked by the neurologic deficits caused by the injury or may be falsely attributed to problems associated with the injury or to iatrogenic trauma. Solitary colonic ulcer should be included in the differential diagnosis of gastrointestinal bleeding in persons with spinal cord injury. Flexible sigmoidoscopy or colonoscopy is recommended for visualization and biopsy of the bleeding lesion.
下消化道出血在脊髓损伤患者中鲜有报道。本文报告了一例四肢瘫痪男性患者发生此类出血的病例，该患者经乙状结肠镜检查及活检诊断为孤立性结肠溃疡。对于脊髓损伤患者，孤立性结肠溃疡的诊断较为困难，因为其临床表现可能被损伤导致的神经功能缺损所掩盖，或者可能被错误地归因于与损伤相关的问题或医源性创伤。脊髓损伤患者发生胃肠道出血时，鉴别诊断应考虑孤立性结肠溃疡。建议进行乙状结肠镜检查或结肠镜检查，以观察出血病变并进行活检。
