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结肠镜检查后急性结肠炎

Acute colitis following colonoscopy.

作者信息

Caprilli R, Viscido A, Frieri G, Latella G

机构信息

Gastroenterology Unit, University of L'Aquila, Italy.

出版信息

Endoscopy. 1998 May;30(4):428-31. doi: 10.1055/s-2007-1001296.

Abstract

Colitis following colonoscopy is an acute, self-limited condition characterized by tenesmus and bloody diarrhea appearing within 48 hours of colonoscopy or sigmoidoscopy. Glutaraldehyde used for disinfection of the endoscopes is considered to be the main etiological agent. Three cases of severe acute self-limited colitis are described in this report. All three were observed within one week, and showed the typical anamnestic, clinical, endoscopic, histological, and radiological features of glutaraldehyde-induced colitis. The main characteristics in these cases were the time relationship with colonoscopy and the severity of the clinical presentation, with symptoms of systemic reaction and intense and diffuse edema of the colonic mucosa. The clinical and morphological features may mimic those of colonic ischemia. All three patients recovered completely within a few days, one spontaneously and two after treatment with steroids, antibiotics, and mesalazine. Acute colitis following colonoscopy should be regarded as one of the complications related to colonoscopy, and it should be taken into account in the differential diagnosis of acute colitis.

摘要

结肠镜检查后结肠炎是一种急性自限性疾病,其特征为在结肠镜检查或乙状结肠镜检查后48小时内出现里急后重和血性腹泻。用于内镜消毒的戊二醛被认为是主要病因。本报告描述了3例严重急性自限性结肠炎病例。所有3例均在1周内观察到,表现出戊二醛诱导性结肠炎典型的既往史、临床、内镜、组织学和放射学特征。这些病例的主要特点是与结肠镜检查的时间关系以及临床表现的严重程度,伴有全身反应症状和结肠黏膜强烈弥漫性水肿。临床和形态学特征可能与结肠缺血相似。所有3例患者均在数天内完全康复,1例自发康复,2例经类固醇、抗生素和美沙拉嗪治疗后康复。结肠镜检查后急性结肠炎应被视为与结肠镜检查相关并发症之一,并应在急性结肠炎的鉴别诊断中予以考虑。

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