Ischemic Colitis: An Useful Clinical Diagnosis, But is it Ischemic?
Ischemic Colitis: An Useful Clinical Diagnosis, But is it Ischemic?
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缺血性结肠炎：一种有用的临床诊断，但它是缺血性的吗？
DOI：
10.1097/00000658-197510000-00009
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发表时间：
1975
影响因子：
9
通讯作者：
J. Wittenberg
中科院分区：
文献类型：
--
作者：
L. Williams;J. Wittenberg
来自波士顿市立医院外科和波士顿大学医学中心的研究表明，缺血性结肠炎与其他类型的结肠异常之间存在差异。人们意识到，这种严格的选择可能已经排除了一些有病变的患者。但这被认为没有显著重叠的问题那么重要。我们的数据仅包括发生在具有以下特征的患者中的急性结肠病：1)50岁以上且没有类似或后续的发作。(2)无胃肠道其他部位缺血性疾病。(3)未用抗生素治疗。4)没有肠道感染的证据。5)直肠镜检查。如果是肯定的话。表明是一种急性粘膜炎症性疾病。6)放射学异常。如果存在的话。提示急性结肠溃烂或渗出过程“，在存活的非手术患者中，演变为愈合或狭窄。7)现有的组织学标本显示粘膜和/或粘膜下的破坏、水肿或出血。我们认识到，无论是组织学评估还是X线改变本身都不是这种病变的特异性，所使用的标准是我们*。如表1所示，55名患者代表46例自发发生的缺血性结肠炎，其中4例为肠系膜下动脉结扎后早期发生的缺血性结肠炎。1例为乙状结肠癌继发的结肠梗阻并发症，1例为缺血性结肠炎，4例为会阴腹会切除术后晚期。对临床特征的分析是相似的，无论这些组是否被分析为
From the Division of Surgery, Boston City Hospital and Boston University Medical Center between ischemic colitis and other types of colonic ab-normality. It is realized that such rigid selection might have excluded some patients with the lesion. but this was felt to be less important than the problem of significant overlap. Our data include only acute colonic disease occuring in a patient with the following characteristics: 1) over the age of 50 and without similar or subsequent episodes. 2) without e vidence of ischemic disease elsewhere within the gastrointestinal tract. 3) not being treated with antibiotics. 4) without evidence of an enteric infection. 5) proctoscopic examination. when positive. indicates an acute mucosal inflammatory disease. 6) radiologic abnormalities. if present. indicate an acute colonic ulcerative or exudative process" which in surviving non-operated patients undergoes evolution to healing or stricture and 7) available histologic specimens dem-onstrating mucosal and/or submucosal destruction, edema or hemorrhage. We recognized that neither the histologic evaluation. nor the barium changes by themselves are specific for this lesion but the criteria used are those which we*"***" and other,"******** have consid-ered as diagnostic of ischemic colitis. As indicated in Table 1, the 55 patients represent 46 with spontaneously occurring ischemic colitis, four with ischemic colitis occurring early after inferior mesenteric artery ligation. one with ischemic colitis occurring as a complication of a colonic obstruction secondary to carcinoma of the sigmoid and 4 occurring late after an abdomino-perineal resection. Analysis of the clinical features is similar whether or not the groups are analyzed as