Tedesco F J
Gastroenterology. 1979 Aug;77(2):295-7.
Most investigators have stressed that the diagnosis of antibiotic associated pseudomembranous colitis is made by proctosigmoidoscopic examination. In our investigation, 6 patients with tissue culture evidence of a clostridial toxin in stools and either normal or only edematous rectal mucosa were studied with total colonoscopy. Five of six patients demonstrated pseudomembranes located in various areas of the colon at a time when the rectosigmoid area was uninvolved. This demonstrates the occurrence of antibiotic associated pseudomembranous colitis which can be missed by routine proctosigmoidoscopy. The incidence of rectal sparing in this disease remains undetermined. Further investigation to determine the occurrence of antibiotic colitis, response to different treatments, or sensitivity of tissue culture assays as a diagnostic aid in antibiotic associated pseudomembranous colitis must take this subgroup into account.
大多数研究者强调，抗生素相关性假膜性结肠炎的诊断是通过直肠乙状结肠镜检查做出的。在我们的研究中，对6例粪便中梭菌毒素组织培养呈阳性且直肠黏膜正常或仅水肿的患者进行了全结肠镜检查。6例患者中有5例在直肠乙状结肠区域未受累时，结肠的不同部位出现了假膜。这表明抗生素相关性假膜性结肠炎的发生可能会被常规直肠乙状结肠镜检查漏诊。该病直肠 spared的发生率尚不确定。进一步研究以确定抗生素结肠炎的发生情况、对不同治疗的反应或组织培养检测作为抗生素相关性假膜性结肠炎诊断辅助手段的敏感性时，必须考虑到这一亚组。
