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肠炎:当前文献的靶向综述

enteritis: a targeted review of current literature.

作者信息

Bathobakae Lefika, Bashir Rammy, Koodirile Atang, Villegas Katrina, Rajab Islam, Perez Edgar W, Cavanagh Yana, El-Sedfy Abraham, Suh Jin S

机构信息

Internal Medicine, St. Joseph's University Medical Center, Paterson, New Jersey, USA.

Internal Medicine, Norwalk Hospital/Yale University, Norwalk, Connecticut, USA.

出版信息

Scand J Gastroenterol. 2025 Jul;60(7):675-685. doi: 10.1080/00365521.2025.2515423. Epub 2025 Jun 6.

Abstract

enteritis (CDE) is a rare but clinically significant form of infection (CDI) affecting the small intestine. CDE poses a diagnostic challenge owing to its rarity, complexity, and nonspecific presentation. The current data is retrospective in the form of case reports and conference proceedings. The lack of widespread awareness and limited literature on CDE often result in diagnostic delays, contributing to increased morbidity. This targeted narrative review sought to consolidate the current knowledge on the epidemiology, pathophysiology, clinical presentation, and management of CDE, addressing a critical gap in the existing literature. Electronic databases, including PubMed, Embase, and Web of Science, were searched for published cases from inception to April 2024. The initial search yielded 2,120 articles, which were filtered using study design, English language, and human subjects. After screening for duplicates and excluding irrelevant articles, 44 articles comprising 49 patients were included in the final review. Of the 49 individual cases reviewed, 25 (51%) were male and 24 (49%) were female. The patients' ranged from 16 to 91 years, with a mean age of 53.4 years. Abdominal pain and diarrhea were the chief complaints reported in 37/49 (76%) and 35/49 (71%) cases, respectively. About 42/49 (86%) cases were effectively treated with antibiotics, while some cases required fecal microbiota transplantation or surgical exploration. Given its course, CDE warrants prompt and appropriate treatment to prevent complications such as fulminant enteritis, compartment syndrome, and bowel perforation.

摘要

艰难梭菌性小肠结肠炎(CDE)是一种罕见但具有临床意义的感染形式,影响小肠。由于其罕见性、复杂性和非特异性表现,CDE带来了诊断挑战。目前的数据以病例报告和会议记录的形式呈现,具有回顾性。对CDE缺乏广泛认识且相关文献有限,常常导致诊断延迟,进而增加发病率。本针对性叙述性综述旨在整合当前关于CDE的流行病学、病理生理学、临床表现和管理的知识,填补现有文献中的关键空白。检索了包括PubMed、Embase和Web of Science在内的电子数据库,以查找从创刊到2024年4月发表的病例。初步检索产生了2120篇文章,根据研究设计、英语语言和人类受试者进行筛选。在筛选重复项并排除无关文章后,最终综述纳入了44篇文章,涉及49例患者。在审查的49例个体病例中,25例(51%)为男性,24例(49%)为女性。患者年龄在16至91岁之间,平均年龄为53.4岁。腹痛和腹泻分别是37/49(76%)和35/49(71%)病例报告的主要症状。约42/49(86%)的病例用抗生素有效治疗,而一些病例需要粪便微生物群移植或手术探查。鉴于其病程,CDE需要及时且适当的治疗,以预防暴发性肠炎、骨筋膜室综合征和肠穿孔等并发症。

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