Sakurai Y, Tsuchiya H, Ikegami F, Funatomi T, Takasu S, Uchikoshi T
Dig Dis Sci. 1979 Dec;24(12):910-5. doi: 10.1007/BF01311944.
Among 56 cases who presented to Kanto-Teishin Hospital complaining of bloody diarrhea or considerable hematochezia of acute onset, 8 cases (14.3%) were considered due to colitis associated with oral ampicillin therapy. The bloody diarrhea, often with abdominal cramps, began 2-7 days after starting the treatment. The dosage of ampicillin taken ranged from 2.0 to 4.5 g. Early total colonoscopy and biopsy revealed marked mucosal hemorrhage with minimal or no inflammatory changes mainly in the right colon. Rectum and sigmoid colon are completely normal except in one case. Symptoms rapidly resolved after the endoscopy. At follow-up colonoscopy, performed 4-12 days later, the mucosal changes had cleared completely. There was no evidence to support a hypersensitivity reaction of the colonic mucosa to ampicillin. We believe that right-sided hemorrhagic colitis is one of the common forms of colitis associated with ampicillin. Its differentiation from other kinds of acute colitis and the importance of early total colonoscopy are discussed.
在关东帝心医院就诊的56例主诉急性起病的血性腹泻或大量便血的患者中，8例（14.3%）被认为是由口服氨苄西林治疗相关的结肠炎所致。血性腹泻常伴有腹部绞痛，在开始治疗后2 - 7天出现。服用氨苄西林的剂量为2.0至4.5克。早期全结肠镜检查及活检显示主要在右结肠有明显的黏膜出血，炎症改变轻微或无炎症改变。除1例患者外，直肠和乙状结肠完全正常。内镜检查后症状迅速缓解。在4 - 12天后进行的随访结肠镜检查中，黏膜改变已完全消失。没有证据支持结肠黏膜对氨苄西林的过敏反应。我们认为右侧出血性结肠炎是氨苄西林相关结肠炎的常见形式之一。本文讨论了其与其他类型急性结肠炎的鉴别以及早期全结肠镜检查的重要性。
