Heloury Y, Plattner V, David V, Nomballais M F
Service de chirurgie pédiatrique, hôpital Mère-Enfant, Nantes, France.
Arch Pediatr. 1996 Sep;3(9):874-6. doi: 10.1016/0929-693x(96)87576-2.
Respiratory diseases associated with ulcerative colitis are rare.
A 14-year-old girl with ulcerative colitis was admitted for a left pneumothorax. She was given corticoidsteroids and enemas of 5 aminosalicylic acid. The pneumothorax was not controlled by pleural drainage and a pleural irritation was performed under thoracoscopy. Recurrence of pneumothorax led to surgical pleurectomy. The following day, a right pneumothorax occurred, also requiring pleurectomy. The pulmonary biopsies showed constrictive bronchiolitis. A restrictive syndrome was confirmed by functional pulmonary examinations. Total colectomy was performed nine months later for the ulcerative colitis.
Ulcerative colitis can be associated with bronchial pathology (bronchitis, bronchiectasis). Occurrence of pneumothorax has never been described; it can be a fortuitous association, but the histological features are not very different from those described in association with ulcerative colitis. The treatment of pneumothorax is difficult if the ulcerative colitis requires corticosteroids.
与溃疡性结肠炎相关的呼吸系统疾病较为罕见。
一名14岁患有溃疡性结肠炎的女孩因左侧气胸入院。她接受了皮质类固醇治疗以及5-氨基水杨酸灌肠。胸腔闭式引流未能控制气胸,遂在胸腔镜下进行胸膜刺激术。气胸复发导致手术性胸膜切除术。次日,又发生了右侧气胸,同样需要进行胸膜切除术。肺部活检显示为缩窄性细支气管炎。通过肺功能检查确诊为限制性综合征。九个月后,因溃疡性结肠炎进行了全结肠切除术。
溃疡性结肠炎可与支气管病变(支气管炎、支气管扩张)相关。气胸的发生此前从未有过描述;这可能是一种偶然关联,但组织学特征与溃疡性结肠炎相关描述并无太大差异。如果溃疡性结肠炎需要使用皮质类固醇,气胸的治疗会很困难。