Gage T P, Gagnier J M
Gastroenterology. 1983 Jan;84(1):171-4.
Abdominal pain is quite common in sickle cell crisis, although the cause of abdominal pain is seldom determined and remains controversial. We have recently seen an 18-yr-old man with sickle cell disease who developed acute abdominal pain during a crisis. Rebound tenderness on physical exam and "thumbprinting" on barium enema examination suggested possible colon infarction. Histopathologic review of the resected ascending colon demonstrated mucosal necrosis and submucosal edema consistent with ischemic colitis. Hypotheses regarding the cause of abdominal pain in sickle crises are reviewed; the pathophysiology of sickle-cell induced vasocclusion and its relation to the development of ischemic colitis in our patient is discussed.
腹痛在镰状细胞危象中相当常见，尽管腹痛的原因很少能确定，且仍存在争议。我们最近接诊了一名18岁的镰状细胞病男性患者，他在一次危象期间出现了急性腹痛。体格检查时的反跳痛以及钡剂灌肠检查时的“拇指印征”提示可能存在结肠梗死。对切除的升结肠进行组织病理学检查显示，黏膜坏死和黏膜下水肿符合缺血性结肠炎表现。本文回顾了关于镰状细胞危象中腹痛原因的各种假说；并讨论了镰状细胞诱导血管闭塞的病理生理学及其与我们这位患者缺血性结肠炎发生的关系。
