Legge D A, Wollaeger E E, Carlson H C
Gut. 1970 Sep;11(9):764-7. doi: 10.1136/gut.11.9.764.
The occurrence of clinical manifestations of mechanical intestinal obstruction in eight cases of systemic amyloidosis is reported. Seven similar cases have been recorded in the literature and are briefly reviewed. Correct diagnosis is important in these cases if useless surgical treatment or prolonged diagnostic investigations are to be avoided. Gastrointestinal involvement by systemic amyloidosis should be considered in a patient presenting with clinical manifestations of mechanical obstruction but paralytic ileus seen on plain films. In these cases an attempt should be made, by means of a barium enema, to exclude an obstructing lesion of the colon or distal small bowel. Once amyloidosis is considered, it can be confirmed easily and safely by biopsy of the rectal or small-intestinal mucosa.
本文报告了8例系统性淀粉样变性患者出现机械性肠梗阻临床表现的情况。文献中已记录了7例类似病例，并进行了简要回顾。若要避免无用的手术治疗或冗长的诊断检查，正确诊断在这些病例中很重要。对于出现机械性肠梗阻临床表现但平片显示为麻痹性肠梗阻的患者，应考虑系统性淀粉样变性累及胃肠道。在这些病例中，应尝试通过钡剂灌肠排除结肠或远端小肠的梗阻性病变。一旦考虑到淀粉样变性，通过直肠或小肠黏膜活检可轻松、安全地确诊。
