Thiele H, Lorenz D
Chirurg. 1985 Dec;56(12):798-802.
This report concerns 14 patients with Morbus Crohn and inflammatory conglomerat tumors between ileo-coecum and sigma. In the case of primary affliction of the ileo-coecum and secondary involvement of the sigma (group A), it is generally sufficient to perform an ileo-coecal resection and suture over the sigma, if a fistula is present. In case of Morbus Crohn afflicting primarily the sigma (group B) or simultaneous involvement of ileo-coecum and sigma (group C), a double resection is necessary. It was always possible to demonstrate the presence of an ileo-sigmoidal fistula by means of barium enema and mostly possible with barium meal or enteroclysis. We consider preoperative colonoscopy with graduated biopsies to be absolutely necessary to determine the exact stage of the illness. Fistulas can be more accurately demonstrated by radiogram than endoscopically.
本报告涉及14例患有克罗恩病且在回盲部和乙状结肠之间有炎性肿块性肿瘤的患者。如果存在瘘管，对于回盲部原发性受累且乙状结肠继发性受累的情况（A组），一般进行回盲部切除并缝合乙状结肠即可。对于主要累及乙状结肠的克罗恩病（B组）或回盲部和乙状结肠同时受累的情况（C组），则需要进行双重切除。通过钡剂灌肠总是能够显示回乙状结肠瘘的存在，通过钡餐或小肠灌肠大多也能显示。我们认为术前进行带分级活检的结肠镜检查对于确定疾病的确切阶段绝对必要。瘘管通过X线照片比通过内镜检查能更准确地显示。
