Cogbill C L, Makkar J, Campana H A, Park Y S
Am Surg. 1977 Mar;43(3):137-43.
Fifteen patients with ischemic colitis were treated; in every case the diagnosis was made at operation or autopsy. Abdominal pain, tenderness, and distention were the most common findings. Five patients had the transient form of the disease, two stricturing, and eight gangrenous. Five patients were operated upon, two because of stricturing disease, three because of gangrene of the colon. Both of the former patients survived, one of the latter. Diagnosis of transient ischemic colitis can be made by barium enema studies. This form of the disease is self-limiting and recovery should be expected. Stricturing ischemic colitis may be diagnosed by barium enema, but doubtful cases will require laparotomy and resection. It is difficult, if not impossible, to differentiate the gangrenous form of the disease from other abdominal catastrophes without operation. When the condition is found at celiotomy, bowel resection without anastomosis is recommended.
对15例缺血性结肠炎患者进行了治疗;每例均在手术或尸检时确诊。腹痛、压痛和腹胀是最常见的表现。5例为疾病的短暂型,2例为狭窄型,8例为坏疽型。5例患者接受了手术,2例因狭窄性疾病,3例因结肠坏疽。前2例患者存活,后3例中1例存活。短暂性缺血性结肠炎可通过钡剂灌肠检查确诊。这种疾病形式是自限性的,有望康复。狭窄性缺血性结肠炎可通过钡剂灌肠诊断,但可疑病例需要剖腹手术和切除。如果不进行手术,很难(即使不是不可能)将坏疽型疾病与其他腹部急症区分开来。当在剖腹手术中发现这种情况时,建议进行肠切除且不进行吻合。