Nyuyen T B, Queré S, Galezowski N, Brisset D
Service de médecine interne, hôpital Saint-Joseph, Paris, France.
Rev Med Interne. 1996;17(1):70-5. doi: 10.1016/0248-8663(96)88399-8.
A 27 year-old man who underwent an intestinal segmental resection for small bowel perforation was hospitalized for chronic abdominal pain with weight loss. Coeliac and mesenteric stenosis was diagnosed and laparotomy was performed. Histologic findings were consistent with Buerger's disease. One month later, he developed intermittent claudication of the left leg, and 8 years later amputation of a toe was performed. Since 1956, 25 cases of abdominal Buerger's disease has been reported in the literature. In eight cases, intestinal involvement inaugurated the disease. The clinical presentation can be various: chronic abdominal pain, mesenteric infartus, occlusion, perforation. Small bowel, colon and rectum can be concerned. The literature points out a mortality rate of 25% in intestinal Buerger's disease, contrasting with a mortality rate of 4% in peripheral forms of the disease. Although rare, intestinal form of Buerger's disease should be diagnosed early, because of its high mortality rate. Doppler of mesenteric arteries may contribute to the early diagnosis.
一名27岁男性因小肠穿孔接受肠段切除术后，因慢性腹痛伴体重减轻入院。诊断为腹腔动脉和肠系膜狭窄并进行了剖腹手术。组织学检查结果符合血栓闭塞性脉管炎。1个月后，他出现左腿间歇性跛行，8年后进行了截趾手术。自1956年以来，文献报道了25例腹部血栓闭塞性脉管炎病例。其中8例以肠道受累为首发症状。临床表现多样：慢性腹痛、肠系膜梗死、梗阻、穿孔。小肠、结肠和直肠均可受累。文献指出，肠道血栓闭塞性脉管炎的死亡率为25%，而该病外周型的死亡率为4%。尽管罕见，但由于肠道型血栓闭塞性脉管炎死亡率高，应尽早诊断。肠系膜动脉多普勒检查有助于早期诊断。
