Nezelof C, Vivien E, Bigel P, Nihoul-Fekete C, Arnaud-Battandier F, Bresson J L, Arhan P, Ricour C
Arch Fr Pediatr. 1985 Dec;42(10):823-8.
The case reported concerns a child with chronic intestinal pseudo-obstruction (CIPO) whose digestive manifestations (intestinal adynamia and distension) were present from the age of 6 months and lasted, despite medical and surgical treatments until 4 years of age, when death occurred. The multiple samplings showed important inflammatory reactions centred on the muscular layers of the small intestine, together with degenerative lesions of the muscular fibres, progressively leading to fibrosis and atrophy of the intestinal wall with secondary and final impairment of the myenteric plexuses. The diagnosis of myositis of the small intestine is extremely rare. It is not part of the usual causes of intestinal adynamia and CIPO, which were reviewed. Hollow visceral myopathy and systemic sclerosis of the GI tract were more especially discussed. For lack of etiopathogenic convincing data and of similar observation in the literature, this case may be temporarily considered as an idiopathic myositis of the small intestine, a potentially new cause of CIPO.
报告的病例是一名患有慢性肠道假性梗阻(CIPO)的儿童,其消化症状(肠道动力缺失和扩张)自6个月大时就出现,尽管接受了药物和手术治疗,但这些症状一直持续到4岁时死亡。多次采样显示,小肠肌层存在严重的炎症反应,同时伴有肌纤维的退行性病变,逐渐导致肠壁纤维化和萎缩,进而引起肌间神经丛继发性和最终性损害。小肠肌炎的诊断极为罕见。它并非肠道动力缺失和CIPO的常见病因,本文对此进行了综述。文中特别讨论了中空内脏肌病和胃肠道系统性硬化症。由于缺乏病因学的确凿数据以及文献中未见类似观察结果,该病例可能暂时被视为小肠特发性肌炎,这是CIPO一种潜在的新病因。