Sabat Nestor, Schulze Bettina
Department of General Surgery, Mackay Base Hospital, Mackay, Australia.
J Surg Case Rep. 2023 Mar 7;2023(3):rjad114. doi: 10.1093/jscr/rjad114. eCollection 2023 Mar.
Portal hypertensive colopathy (PHC) is a colonic phenomenon commonly causing chronic gastrointestinal bleeding or less commonly a life-threatening acute colonic hemorrhage. An otherwise well, 58-year-old female presents general surgeons a diagnostic dilemma for symptomatic anemia. An interesting case where the rare and elusive PHC was diagnosed on colonoscopy, which led to the diagnosis of liver cirrhosis without evidence of oesophageal varices. Although PHC is most common in patients with cirrhosis, it is likely still underdiagnosed, given the current stepwise treatment approach of these cirrhotic patients often leads to treatment of the PHC alongside PHG without establishing a diagnosis. Instead, this case presents a generalised approach to patients with underlying portal and sinusoidal hypertension due to a variety of causes, and the endoscopic and radiological findings, which lead to their successful diagnosis and medical management of the gastrointestinal bleeding.
门静脉高压性结肠病（PHC）是一种结肠病变，通常导致慢性胃肠道出血，较少情况下会引发危及生命的急性结肠出血。一名58岁身体健康的女性因症状性贫血给普通外科医生带来了诊断难题。这是一个有趣的病例，通过结肠镜检查诊断出罕见且难以捉摸的PHC，进而诊断出肝硬化但无食管静脉曲张证据。尽管PHC在肝硬化患者中最为常见，但鉴于目前对这些肝硬化患者的逐步治疗方法常常导致在未明确诊断的情况下同时治疗PHC和门静脉高压性胃病（PHG），PHC可能仍未得到充分诊断。相反，该病例展示了针对各种原因引起的潜在门静脉和窦性高血压患者的综合方法，以及导致其胃肠道出血成功诊断和药物治疗的内镜及影像学检查结果。
