Colonic strictures mimicking Crohn’s disease
Colonic strictures mimicking Crohn’s disease
复制标题
类似于克罗恩病的结肠狭窄
DOI：
10.1136/gutjnl-2019-320172
复制
发表时间：
2021
期刊：
影响因子：
24.5
通讯作者：
Ohtsuka Kazuo
中科院分区：
文献类型：
--
作者：
Takenaka Kento;Kimura Maiko;Ohtsuka Kazuo
一名38岁的女性，有3个月的腹痛、腹泻和体重减轻2公斤的病史。最初进行的平扫CT显示轻微腹水，没有任何肠道炎症或肿瘤的证据。考虑到患者的症状和年龄，怀疑IBD，并进行了结肠镜检查，结果显示结节不规则和乙状结肠严重狭窄，阻碍了内镜的通过。狭窄的结肠活检显示正常上皮。由于未能获得明确诊断，患者被转诊至我们的大学医院，实验室检查显示没有贫血或C反应蛋白升高，肿瘤标志物水平（癌胚抗原（CEA）和碳水化合物抗原（CA）19-9）在正常范围内。使用结肠镜（GIF-XP 290 N）进行的结肠镜检查显示整个结肠有多个粘膜下结节性病变和多个节段性狭窄。病变外观与克罗恩病的“鹅卵石外观”相似，但没有溃疡（图1A）。使用泛影葡胺的荧光透视显示多个狭窄肠段（所谓的“弦征”，图1B）。没有慢性炎症的迹象
A 38-year-old woman presented with a 3-month history of abdominal pain, diarrhoea and 2 kg weight loss. Plain CT performed initially revealed minor ascites, without any evidence of bowel inflammation or tumours. Considering the patient’s symptoms and age, IBD was suspected and colonoscopy was performed, which revealed nodular irregularity and a severe stricture in the sigmoid colon that prevented the passage of the scope. Colonic biopsy of the stricture revealed a normal epithelium. Because of the failure to obtain a definitive diagnosis, the patient was referred to our university hospital.Laboratory tests revealed no anaemia or C reactive protein elevation, and tumour marker levels (carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19–9) were within the normal ranges. Colonoscopy performed using an ultrathin colonoscope (GIF-XP290N) revealed multiple submucosal nodular lesions and multiple segmental strictures throughout the colon. The lesions were similar in appearance to the ‘cobblestone appearance’of Crohn’s disease but without ulceration (figure 1A). Fluoroscopy using gastrografin revealed multiple stenotic bowel segments (so-called ‘string sign’, figure 1B). No evidence of chronic inflammation,
影响因子：
1.3
作者：
Jang, HJ;Lim, HK;Choi, D
通讯作者：
Choi, D