Teasdale C, Mortensen N J
Br J Surg. 1983 Jan;70(1):44-7. doi: 10.1002/bjs.1800700117.
Acute necrotizing colitis is a rare complication of colonic obstruction. Six cases occurring during a 20-month period are described. The presenting features were those of colonic obstruction with shock but without perforation. At laparotomy changes ranged from mucosal necrosis to frank gangrene in the colon proximal to the obstructing lesion. Gram stains of resected colon showed Gram-positive bacilli, resembling clostridia, invading the mucosa and submucosa. Two patients treated by defunctioning colostomy alone died but the remaining 4 survived after total colectomy. The cause is not known but raised intraluminal pressure may result in terminal mucosal ischaemia allowing anaerobic organisms to invade the bowel wall.
急性坏死性结肠炎是结肠梗阻的一种罕见并发症。本文描述了在20个月期间发生的6例病例。其临床表现为结肠梗阻伴休克，但无穿孔。剖腹探查时，梗阻病变近端结肠的变化范围从黏膜坏死到明显的坏疽。切除结肠的革兰氏染色显示革兰氏阳性杆菌，类似于梭菌，侵入黏膜和黏膜下层。仅接受造瘘术治疗的2例患者死亡，其余4例在全结肠切除术后存活。病因不明，但管腔内压力升高可能导致终末黏膜缺血，使厌氧菌侵入肠壁。
