Kruschewski M, Busch C, Dörner A, Lierse W
Chirurgische Abteilung, Klinikum Niederberg, Velbert.
Langenbecks Arch Chir. 1995;380(5):253-9. doi: 10.1007/BF00184098.
The etiology and the pathogenesis of the chronic inflammatory bowel diseases known as Crohn's disease and ulcerative colitis have not been defined. Therefore, in this study the main emphasis was placed on description of the pathologic anatomy. Disturbed blood supply and vascular disorders have been discussed as etiopathogenetic factors. The results in the literature are frequently contradictory. For this reason, the vascular system of the colon in Crohn's disease and ulcerative colitis was systematically examined by means of various morphological methods in this study. Microvascular corrosion casting and translucent specimens were taken from operative specimens taken from 12 patients with Crohn's disease and 8 with ulcerative colitis. For comparison, tumor-free parts of 6 colon cancer specimens were examined. The evaluation was done by scanning electron- and/or stereoscopic microscopy. In the presence of chronic inflammatory bowel disease dilatation of the submucosal veins, caliber differences in the tunica muscularis and rarefaction of the penetrating blood vessels were found. In summary, an impairment of the blood flow in the tunica muscularis can be postulated. For the first time, the resulting venous stasis has been described, in contrast to the previously described disturbed arterial blood supply.
被称为克罗恩病和溃疡性结肠炎的慢性炎症性肠病的病因和发病机制尚未明确。因此,本研究主要侧重于病理解剖学的描述。血液供应紊乱和血管疾病已被作为病因学因素进行讨论。文献中的结果常常相互矛盾。出于这个原因,本研究通过各种形态学方法对克罗恩病和溃疡性结肠炎患者的结肠血管系统进行了系统检查。从12例克罗恩病患者和8例溃疡性结肠炎患者的手术标本中获取微血管铸型和半透明标本。作为对照,对6例结肠癌标本的无瘤部分进行了检查。通过扫描电子显微镜和/或立体显微镜进行评估。在慢性炎症性肠病患者中,发现黏膜下静脉扩张、肌层管径差异以及穿通血管稀疏。总之,可以推测肌层血流存在障碍。与之前描述的动脉血液供应紊乱不同,首次描述了由此导致的静脉淤滞。