Lesions of the ileum associated with ulcerative colitis
Lesions of the ileum associated with ulcerative colitis
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与溃疡性结肠炎相关的回肠病变
DOI：
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发表时间：
1956
影响因子：
9.6
通讯作者：
B. Counsell
中科院分区：
文献类型：
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作者：
B. Counsell
关于溃疡性结肠炎病例中回肠下部病变的临床意义和发生率存在相当大的意见分歧。虽然人们普遍认为，最常见的回肠炎是由患病结肠的逆行扩散引起的，并且使用了术语“回肠炎”，但这种机制并不能解释所有病例。还有另一种类型的回肠炎，偶尔发现近端部分梗阻回肠造口术。Warren和McKittrick（1951）最初认识并称之为“回肠造口功能障碍”的这种疾病，在更严重的病例中，其病理特征是回肠中存在溃疡，表面上类似于逆行型回肠炎。这表明，由于这种相似性，这两种情况在过去被混淆，并被认为是同一病理过程的变体。由此造成的无法区分两者的情况导致了最严重的后果。关于与溃疡性结肠炎相关的区域性回肠炎（克罗恩病）的罕见病例，尽管通常在大体病理学上容易与已经提到的回肠炎类型区分开来，但在溃疡性结肠炎回肠病理学的任何研究中必须考虑到它们。最后还有布鲁克和库克（1951）描述的“回结肠炎”。有人认为这主要是一种与脂肪性结肠炎有关的回空肠炎，它在结肠中产生与溃疡性结肠炎难以区分的继发性变化。建议回顾文献，并提出和分析各种类型的回肠疾病发现与溃疡性结肠炎已观察到在圣马克医院在过去三年中，希望这将有助于澄清这个困难和混乱的主题的临床意义和病理。
THERE have been considerable differences of opinion regarding the clinical significance and incidence of lesions of the lower ileum in cases of ulcerative colitis. For while it is generally agreed that the most commonly found type of ileitis is caused by a retrograde spread from the diseased colon, and the term ‘ backwash ’ has been used, this mechanism does not explain all cases. There is another type of ileitis which is occasionally found proximal to a partially obstructed ileostomy. This condition, originally recognized and called ‘ ileostomy dysfunction ’ by Warren and McKittrick (I951), is characterized pathologically in the more severe cases by the presence of ulcers in the ileum which superficially resemble those of the retrograde type of ileitis. It is suggested that as a result of this resemblance, these two conditions have in the past been confused and considered as variants of the same pathological process. The resultant failure to differentiate the one from the other has led to the gravest consequences. With regard to the rare cases of regional ileitis (Crohn’s disease) associated with ulcerative colitis, although usually readily distinguished on gross pathological grounds from the types of ileitis already mentioned, they must be considered in any study of the pathology of the ileum in ulcerative colitis. Finally there is the condition described by Brooke and Cooke (1951) of ‘ ileocolitis ’. It has been suggested that this is primarily an ileojejunitis associated with steatorrhea which produces secondary changes in the colon indistinguishable from those of ulcerative colitis. It is proposed to review the literature, and present and analyse cases of the various types of ileal disease found in association with ulcerative colitis which have been observed at St. Mark’s Hospital during the last three years, in the hope that this will help to clarify the clinical significance and pathology of this difficult and confused subject.