[Value of abdominal-pelvic computed tomography in adult rheumatoid purpura].

[Value of abdominal-pelvic computed tomography in adult rheumatoid purpura].
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腹盆腔计算机断层扫描在成人类风湿性紫癜中的价值

DOI：
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发表时间：
2001
期刊：
La Revue de medecine interne
影响因子：
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通讯作者：
O. Aumaître
O. Aumaître
中科院分区：
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文献类型：
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作者：
H. Mahamedi;M. André;C. Privat;I. Delévaux;M. D’Incan;J. Piette;C. Francès;O. Aumaître

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目的 过敏性紫癜是一种少见的成年期疾病。腹部受累可能会恶化短期预后，并有理由进行药物治疗以避免手术。 方法 对6例成人过敏性紫癜患者(男4例，女2例，年龄19-74岁)在治疗前进行了腹盆CT检查。腹部症状伴发紫癜性皮疹2例，另2例随之而来。 结果 小肠总是受累于壁层增厚，在3例患者中观察到靶征。病变位于十二指肠2例，空肠2例，回肠5例。一例患者累及两个节段，另一例患者累及三个节段。腹膜积液总是存在。CT未发现结肠病变。一旦知道结果，所有患者都接受了类固醇治疗，其中5名患者最初静脉注射甲基强的松龙，剂量从每天80毫克到1000毫克不等。随访时，所有患者均未接受手术治疗。 结论 腹盆腔CT扫描显示有肠血管炎征象。探查潜在的肿瘤或最终引起腹痛的其他原因，然后开始类固醇治疗，结果良好。腹部CT对过敏性紫癜腹部受累的诊断有一定帮助。
PURPOSE Henoch-Schonlein purpura is a rare eventuality in adulthood. Abdominal involvement can worsen the short-term prognosis and justify medical treatment to avoid surgery. METHODS Abdominopelvic computed tomography (CT) was performed in six adult patients (four men and two women; age range, 19-74 years) with Henoch-Schonlein purpura before any treatment. Abdominal symptoms were concomitant with the purpuric rash in two cases and followed it in the other cases. RESULTS The small bowel was always involved with a parietal thickening, and the target sign was observed in three patients. The lesions were located in the duodenum in two patients, the jejunum in two and the ileum in five. Two segments were involved in one patient and three segments in another patient. A peritoneal effusion was always present. No colonic lesion was discovered on CT. Once the results were known, all patients received steroids with initially intravenous methylprednisolone in five patients at doses ranging from 80 to 1,000 mg/day. On follow-up, none of the patients underwent surgery. CONCLUSION Abdominopelvic CT scan demonstrated signs suggestive of intestinal vasculitis. An underlying neoplasia or an eventual other cause of abdominal pain were explored and a steroid therapy was then began with a good outcome. Abdominal CT can be helpful in the diagnosis of abdominal involvement in Henoch-Schonlein purpura.