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肠气肿伴血吸虫病:一例报告。

Pneumatosis cystoides intestinalis accompanied by schistosomiasis: a case report.

机构信息

Department of Pathology, Minhang Hospital, Fudan University, Shanghai, P. R. China.

Department of Gastrointestinal Surgery, Minhang Hospital, Fudan University, Shanghai, P. R. China.

出版信息

J Int Med Res. 2022 Jun;50(6):3000605221105160. doi: 10.1177/03000605221105160.

Abstract

Pneumatosis cystoides intestinalis (PCI) is a rare disease that most frequently occurs in the large and small intestine and has no obvious clinical symptoms. The main pathological feature is the presence of air-filled cysts in the intestinal submucosa, intermuscular wall, and subserous membrane. Conservative treatment is the first choice when no serious complications are present, whereas timely surgical treatment is needed for serious and life-threatening complications. This report presents the clinical and pathological analysis of PCI in a man in his early 90s. The patient was hospitalized because of acute abdomen and diagnosed with perforation of the sigmoid colon due to PCI with schistosomiasis after emergency surgery. Emergency partial sigmoid colon resection and permanent colostomy were performed under general anesthesia. Preoperative diagnosis of PCI is difficult because of the nonspecific clinical manifestations and endoscopic findings, and missed diagnosis and misdiagnosis easily occur. Pure PCI has no specific symptoms and does not require special treatment, and there is a lack of special treatment methods in clinical practice. However, when PCI is combined with other intestinal diseases such as schistosomiasis enteropathy, intestinal perforation is likely to occur, leading to severe acute abdomen with the need for prompt surgical treatment.

摘要

肠气肿症(PCI)是一种罕见的疾病,主要发生于大肠和小肠,无明显临床症状。主要的病理特征是肠黏膜下层、肌间壁和浆膜下存在充满气体的囊泡。在没有严重并发症的情况下,首选保守治疗,而对于严重且危及生命的并发症,则需要及时手术治疗。本报告介绍了一位 90 多岁男性患者的 PCI 的临床和病理分析。该患者因急性腹痛住院,经急诊手术后诊断为 PCI 合并血吸虫病导致乙状结肠穿孔。在全身麻醉下进行了紧急部分乙状结肠切除和永久性结肠造口术。由于 PCI 的临床表现和内镜检查无特异性,术前诊断困难,容易导致漏诊和误诊。单纯 PCI 无特异性症状,无需特殊治疗,临床实践中缺乏特殊治疗方法。然而,当 PCI 合并血吸虫病性肠炎等其他肠道疾病时,可能会发生肠穿孔,导致严重的急性腹痛,需要及时手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d49/9344114/f33241526644/10.1177_03000605221105160-fig1.jpg

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