Buts J P, Weber A M, Roy C C, Morin C L
Gastroenterology. 1977 Oct;73(4 Pt 1):823-7.
Pseudomembranous enterocolitis is reported in five children. The clinical syndrome, characterized by the acute onset of profuse diarrhea, occurred postoperatively in 2 patients. All the patients had received or were taking antibiotics (penicillin, ampicillin, clindamycin). The disease was severe in 4 persons who presented with hypoproteinemia. Related complications were edema, ascites, pleural effusion, septicemia and/or shock. The diagnosis was made on the basis of typical rectosigmoidoscopic findings. Despite intensive therapy 2 children died. The use of parenteral nutrition is advocated in severe cases with exudative enteropathy. When profuse diarrhea occurs postoperatively or does not rapidly subside with discontinuation of antibiotic therapy, a high index of suspicion should be maintained, even in children, for the possibility of pseudomembranous enterocolitis. An emergency rectosigmoidoscopy should be done in order to make an early diagnosis.
有5名儿童被报告患有伪膜性小肠结肠炎。该临床综合征的特征为急性发作的大量腹泻,2例患者在术后出现。所有患者均接受过或正在服用抗生素(青霉素、氨苄青霉素、克林霉素)。4例患者病情严重,出现低蛋白血症。相关并发症有水肿、腹水、胸腔积液、败血症和/或休克。诊断基于典型的直肠乙状结肠镜检查结果。尽管进行了强化治疗,仍有2名儿童死亡。对于严重的渗出性肠病病例,提倡使用肠外营养。当术后出现大量腹泻或停用抗生素治疗后腹泻未迅速缓解时,即使是儿童,也应高度怀疑伪膜性小肠结肠炎的可能性。应进行急诊直肠乙状结肠镜检查以便早期诊断。