Gasbarrini G, Corazza G R, Biagi F, Brusco G, Andreani M L, Malservisi S, Greco A V
Istituto di Medicina Interna, Università Cattolica Sacro Cuore, Roma.
Riv Eur Sci Med Farmacol. 1994 Sep-Dec;16 Suppl 1:39-68.
The clinical consequences of intestinal malabsorption are extremely variable and a dissociation between malabsorption, malabsorption syndrome and enteropathy is often noted. Enteropathy does not always results in malabsorption and in an alteration of the tests exploring the absorptive function. The following have particular relevance in clinical practice: coeliac disease, malabsorption induced by microbiologic agent (including Whipple's disease), post-surgical malabsorption and selective carbohydrate malabsorption. In particular, coeliac disease has been analyzed in its various aspects, from studies with organ cultures to immunological hypotheses, from the classical variety to subclinical forms and to serious complications, such as enteropathy-associated T cell lymphoma. Malabsorption syndromes are dramatically underdiagnosed: in the typical case of coeliac disease, enteropathy represents a clinical iceberg, and the discovery of the submerged portion, represented by the polymorphous subclinical varieties, has just started. As far as intestinal malabsorption is concerned, the main clinical problem regards diagnosis.
肠道吸收不良的临床后果差异极大，而且常可注意到吸收不良、吸收不良综合征和肠病之间的脱节。肠病并不总是导致吸收不良以及探索吸收功能的检查结果改变。以下情况在临床实践中具有特殊相关性：乳糜泻、微生物因素引起的吸收不良（包括惠普尔病）、术后吸收不良和选择性碳水化合物吸收不良。特别是，乳糜泻已从各个方面进行了分析，从器官培养研究到免疫学假说，从经典类型到亚临床形式，再到严重并发症，如肠病相关T细胞淋巴瘤。吸收不良综合征的诊断严重不足：在典型的乳糜泻病例中，肠病就像一座临床冰山，而由多形性亚临床类型所代表的水下部分的发现才刚刚开始。就肠道吸收不良而言，主要的临床问题在于诊断。
