Nelson R L, Schuler J J
Surg Gynecol Obstet. 1982 Jan;154(1):27-33.
The rectum is rarely involved in ischemic colitis because of its abundant collateral blood supply. Thus, other forms of inflammatory intestinal disease, such as antibiotic associated or infectious colitis, are considered to be more likely if the rectum is inflamed. Yet, collateral flow develops slowly. Therefore, ischemic proctitis does occur in instances of sudden occlusion of the major blood supply to the rectum, such as after an aortic operation. The histopathology of this condition does not differ from that of infectious colitides, and the diagnosis of ischemic colitis can only be confirmed after careful culturing and assessment of the stool for clostridial toxins. Penile Doppler pressure measurements, as demonstrated in the patient presented herein, may be a simple, noninvasive method of inferring rectal blood flow and, therefore, aid in the diagnosis of ischemic proctitis.
由于直肠有丰富的侧支血液供应，缺血性结肠炎很少累及直肠。因此，如果直肠发生炎症，其他形式的炎症性肠病，如抗生素相关性或感染性结肠炎，被认为更有可能。然而，侧支血流发展缓慢。因此，在直肠主要血液供应突然闭塞的情况下，如主动脉手术后，确实会发生缺血性直肠炎。这种情况的组织病理学与感染性结肠炎并无不同，缺血性结肠炎的诊断只能在仔细培养和评估粪便中的梭菌毒素后才能确定。如本文所述患者的阴茎多普勒压力测量，可能是一种推断直肠血流的简单、非侵入性方法，因此有助于缺血性直肠炎的诊断。
