Glutaraldehyde colitis following endoscopy: clinical and pathological features and investigation of an outbreak.
Glutaraldehyde colitis following endoscopy: clinical and pathological features and investigation of an outbreak.
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内窥镜检查后戊二醛结肠炎：临床和病理特征以及暴发调查。
DOI：
10.1016/0016-5085(95)90227-9
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发表时间：
1995
期刊：
影响因子：
29.4
通讯作者：
Lagarde,S
中科院分区：
文献类型：
--
作者：
West,AB;Kuan,SF;Bennick,M;Lagarde,S
虽然潜在的有毒化合物通常用于消毒内窥镜，但其意外引入胃肠道的报告很少，通常归因于内窥镜通道内的消毒剂残留。本病例报告描述了4例患者中戊二醛诱导的结肠炎的临床特征和粘膜损伤的病理学，其中至少1例患者的消毒剂未保留在内窥镜本身中。在3个月内，3名患者在乙状结肠镜检查后<6小时发生了严重的急性直肠结肠炎，显示无异常，在小型内窥镜检查单位进行。对装置方案的调查表明，最可能的原因是内窥镜通道中残留2%戊二醛消毒剂，并进行了变更以防止这种情况。当5个月后发生第四例时，发现戊二醛的来源是将水瓶连接到内窥镜的管道，该管道经过严格消毒，但在病例之间冲洗不一致。在活检标本中，谷氨酰胺诱导的结肠炎似乎与缺血性结肠炎相似，不能仅通过组织学分析进行诊断。在结肠镜检查后24小时内发生的急性结肠炎未显示异常，应视为医源性，并应导致对内镜设备清洁和消毒程序的调查。
Although potentially noxious compounds are used routinely to disinfect endoscopes, reports of their inadvertent introduction to the gastrointestinal tract, usually attributed to the retention of disinfectant within endoscope channels, are rare. This case report describes the clinical features of glutaraldehyde-induced colitis and the pathology of the mucosal injury in four patients, in at least one of whom the disinfectant was not retained in the endoscope itself. Within 3 months, three patients experienced severe acute proctocolitis <6 hours after a sigmoidoscopy showing no abnormalities, performed in a small endoscopy unit. Investigation of the unit's protocols suggested that the most likely cause was retention of 2% glutaraldehyde disinfectant in the endoscope channels, and changes were made to prevent this. When a fourth case occurred 5 months later, the source of the glutaraldehyde was found to be the tubing connecting water bottles to the endoscopes, which was disinfected rigorously but flushed inconsistently between cases. Glutaraldehyde-induced colitis seems similar to ischemic colitis in biopsy specimens and cannot be diagnosed by histological analysis alone. Acute colitis occurring within 24 hours of a colonoscopy showing no abnormalities should be considered iatrogenic and should lead to an investigation of procedures in use for cleaning and disinfecting endoscopic equipment.
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过氧化氢产生气体栓塞。
DOI：
10.1056/nejm196708032770504
发表时间：
1967
期刊：
The New England journal of medicine
影响因子：
--
作者：
A. Shaw;A. Cooperman;J. Fusco
通讯作者：
J. Fusco
DOI：
10.1016/0195-6701(91)90014-y
发表时间：
1991
期刊：
The Journal of hospital infection
影响因子：
--
作者：
J. Babb;C. Bradley
通讯作者：
C. Bradley
可逆性缺血性结肠炎的临床过程。
影响因子：
29.4
作者：
M. Dawson;J. Schaefer
通讯作者：
J. Schaefer
影响因子：
29.4
作者：
GRIFFIN, PM;OLMSTEAD, LC;PETRAS, RE
通讯作者：
PETRAS, RE
直肠内超声检查后戊二醛诱发的直肠炎：发病风险比预期更高？
影响因子：
7.7
作者：
P. Burtin;O. Ruget;R. Petit;J. Boyer
通讯作者：
J. Boyer