Johanns W, Jakobeit C, Louis W, Greiner L
Medizinische Klinik A, Universität Witten-Herdecke, Kliniken der Stadt Wuppertal.
Z Gastroenterol. 1994 Aug;32(8):444-6.
A 59-year-old patient was treated for six years assuming Crohn's disease. Recurrent segmental colitis, spontaneous perforation of the jejunum and chronic weight loss were suggestive of this diagnosis despite a missing typical histology, even in the resected part of jejunum. Only unspecific inflammatory changes were found. Typical angina abdominalis occurred late. Angiography showed a complete occlusion of the coeliacaxis and both mesenteric arteries. Only the slow progress of occlusion of the visceral arteries with extensive collateral circulation from iliacal arteries explains the absence of severe bowel infarction. After aortomesenteric bypass operation the patient is without any complaint.
一名59岁的患者被诊断为克罗恩病并接受了六年的治疗。尽管缺乏典型的组织学表现，即使在空肠切除部分也是如此，但复发性节段性结肠炎、空肠自发性穿孔和慢性体重减轻提示了这一诊断。仅发现非特异性炎症改变。典型的腹部绞痛出现较晚。血管造影显示腹腔动脉和肠系膜上、下动脉完全闭塞。只有内脏动脉闭塞进展缓慢且有来自髂动脉的广泛侧支循环，才能解释为何没有严重的肠梗死。在进行主动脉肠系膜旁路手术后，患者没有任何不适。
