Inban Pugazhendi, Carredo Carlo Kristian C, Arslan Faiza, Odoma Victor A, Okobia Isioma, Adegbite Abiodun, Sharma Shristi, Kc Sandip, Zahdeh Tamer, Rentiya Zubir S
Department of General Medicine, Government Medical College, Omandurar, Chennai, IND.
Department of General Surgery, Cebu Institute of Medicine, Cebu, PHL.
Cureus. 2023 Jul 12;15(7):e41792. doi: 10.7759/cureus.41792. eCollection 2023 Jul.
Ischemic colitis is thought to be an injury to the colon as a result of reduced blood flow. Certain infectious diseases such as the Epstein-Barr virus can aid in the reduction of blood flow. The insult can range from inflammation and superficial injury to full-thickness necrosis. The typical regions affected are the "watershed" areas of the colon: the splenic flexure, the rectosigmoid junction, and the right colon. Because patients can present with a wide spectrum of symptoms from vague abdominal discomfort to complete abdominal catastrophe, the diagnosis of ischemic colitis is sometimes challenging to make. Patients typically present with the acute onset of crampy abdominal pain and usually pass blood mixed with stool within 24 hours. Endoscopically, ischemia is suspected in the presence of bluish hemorrhagic nodules from submucosal bleeding, cyanotic or necrotic mucosa with bleeding ulcerations, or a segmental distribution with an abrupt transition point between injured and normal mucosa. We present a case of an 80-year-old male with a history of hypertension, hyperlipidemia, and basal cell carcinoma of the scalp diagnosed with ischemic colitis associated with positive Epstein-Barr virus B cell lymphoma.
缺血性结肠炎被认为是由于血流减少导致的结肠损伤。某些传染病，如爱泼斯坦-巴尔病毒，可导致血流减少。损伤范围可从炎症和浅表损伤到全层坏死。典型的受累区域是结肠的“分水岭”区域：脾曲、直肠乙状结肠交界处和右半结肠。由于患者的症状范围广泛，从模糊的腹部不适到完全的腹部急症，缺血性结肠炎的诊断有时具有挑战性。患者通常表现为突发性痉挛性腹痛，通常在24小时内排出混有血液的粪便。在内镜检查中，若存在黏膜下出血形成的蓝色出血结节、伴有出血性溃疡的发绀或坏死黏膜，或损伤黏膜与正常黏膜之间有突然过渡点的节段性分布，则怀疑有缺血。我们报告一例80岁男性病例，该患者有高血压、高脂血症和头皮基底细胞癌病史，诊断为与爱泼斯坦-巴尔病毒B细胞淋巴瘤阳性相关的缺血性结肠炎。
