Carr N D, Wells S, Haboubi N Y, Salem R J, Schofield P F
Ann R Coll Surg Engl. 1986 Sep;68(5):264-6.
The present paper describes the presentation and management of 9 patients who developed dilatation in the colon during the course of spontaneous ischaemic colitis. The length of history varied from 16 hours to 6 weeks. The patients usually had diarrhoea and abdominal pain but no bleeding and posed a difficult diagnostic problem. At laparotomy, three distinct types of colonic dilatation were recognised. Dilatation of non-diseased colon proximal to localised ischaemic segments occurred in 2 patients, 3 patients exhibited dilatation of obviously gangrenous colon, 4 patients showed dilatation of ischaemic but possibly viable colon, yet in 1 of these, multiple sealed perforations were present. Resection of the obvious or possibly gangrenous colon was the treatment used but in the 2 patients with dilatation due to stricture, transverse colostomy alone was employed.
本文描述了9例在自发性缺血性结肠炎病程中出现结肠扩张患者的临床表现及治疗情况。病史时长从16小时至6周不等。患者通常有腹泻和腹痛症状，但无出血情况，这给诊断带来了难题。剖腹手术时，识别出三种不同类型的结肠扩张。2例患者出现局部缺血段近端非病变结肠的扩张，3例患者表现为明显坏疽性结肠的扩张，4例患者显示缺血但可能存活的结肠扩张，其中1例存在多个封闭性穿孔。对于明显或可能坏疽的结肠采用了切除治疗，但对于2例因狭窄导致扩张的患者，仅进行了横结肠造口术。
