Martinez C R, Gilman R H, Rabbani G H, Koster F
AJR Am J Roentgenol. 1982 Jun;138(6):1089-93. doi: 10.2214/ajr.138.6.1089.
Twenty-seven patients with severe acute amebic dysentery were studied at the International Centre for Diarrhoeal Diseases Research Hospital in Dacca, Bangladesh. Patients were divided into two groups according to their pretreatment proctoscopic mucosal pattern. Those with mild lobular patterns (five patients) had a milder illness; posttreatment air-contrast barium enema examinations were normal except for subtle mucosal abnormalities in two (40%). In contrast, patients with necrotic ulceration proctoscopic patterns (22 patients) had a more severe illness; 19 (86%) had ulcerations, haustral abnormalities, and/or strictures demonstrated on posttreatment barium enema examinations. Persistent strictures were found in eight of 10 patients with necrotic ulceration patterns who had sequential barium enema examinations up to 9 months after treatment. These observations indicate that despite successful therapy with metronidazole, there is a high incidence of persisting colonic abnormalities in patients with the necrotic ulceration pattern. Since proctoscopy has a useful predictive value, it should be performed in all patients with severe amebic dysentery.
在孟加拉国达卡的国际腹泻病研究中心医院，对27例重症急性阿米巴痢疾患者进行了研究。根据患者治疗前的直肠镜黏膜形态将其分为两组。小叶形态较轻的患者（5例）病情较轻；治疗后气钡双重造影检查除2例（40%）有轻微黏膜异常外均正常。相比之下，直肠镜检查显示有坏死性溃疡形态的患者（22例）病情更严重；19例（86%）在治疗后的钡灌肠检查中显示有溃疡、袋形异常和/或狭窄。在10例有坏死性溃疡形态且在治疗后长达9个月进行了连续钡灌肠检查的患者中，有8例发现有持续性狭窄。这些观察结果表明，尽管甲硝唑治疗成功，但有坏死性溃疡形态的患者结肠异常持续存在的发生率很高。由于直肠镜检查具有有用的预测价值，因此应对所有重症阿米巴痢疾患者进行直肠镜检查。
