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ID:14369202
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页数:33页
时间:2018-07-28
《溃疡性结肠炎的诊断与治疗》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、溃疡性结肠炎的诊断与治疗临床症状常见:腹痛、发热(<38˚C)、腹泻、血便、消瘦。肠外表现:关节炎、口腔溃疡、强直性脊柱炎(HLA-B27)、微型硬化性胆管炎。内镜检查及X线检查内镜检查表现:中毒性巨结肠是内镜绝对禁忌症钡剂灌肠:铅管征、毛刺样改变、粘膜颗粒粗糙EndoscopicfeaturesofactiveulcerativecolitisFigure4-1.Endoscopicfeaturesofactiveulcerativecolitis.Findingsincludediffuselyerythemato
2、us,edematous,andgranularmucosawithareasofsubmucosalhemorrhageand,whensevere,frankmucopurulentexudate.Inflammationinvariablybeginsintherectumandextendsproximallyforvaryingextents.Thechronicityoftheprocessissuggestedbythelossofcolonichaustrations;otherwise,theendo
3、scopicpictureisnonspecificandcouldbeconsistentwithacuteinfectiouscolitis,chroniculcerativeorCrohn`scolitis,oranynumberofotherspecificcausesofcolitis.A,Milddistalulcerativecolitiswithdiffuseerythemaandfriabilitywelldemarcatedfromthenormalmucosamoreproximallyisdep
4、icted.B,Thisexampleshowsmoderatelysevereulcerativecolitiswithirregular,inflamed,ulceratedmucosaandapatchyexudate.UlcerativecolitisinremissionFigure4-2.Ulcerativecolitisinremission.Thenormalvascularpatternisabsentandawhitescarindicatesthesiteofapreviousulcer.Seve
5、reulcerativecolitisFigure4-3.Severeulcerativecolitis.Themucosashowsextensiveulcerationanddiffusethickeningwithaninflammatoryinfiltrate.IncontrasttoCrohn`scolitis,theulcerationlacksdepth.ChroniculcerativecolitisFigure4-5.Chroniculcerativecolitis.Inlong-standingul
6、cerativecolitis,themucosahasanatrophicandscarredappearancewithabluntedvascularpattern.Pseudopolypsareoftenpresent.SevereulcerativecolitiswithpseudopolypsFigure4-4.Severeulcerativecolitiswithpseudopolyps.Inadditiontoseveremucosalulcerationandinflammation,chronicu
7、lcerativecolitisisoftenassociatedwiththeformationofpseudopolyps,whichrepresentislandsofregeneratingmucosaandexuberantinflammationamidstdiffusemucosaldestruction.Pseudopolypshavenomalignantpotential.SevereulcerativecolitisFigure4-6.Radiographicappearanceofsevereu
8、lcerativecolitis.Thissingle-contrastbariumenemademonstratesthetypicalraggedandulcerativeappearanceofthemucosainactiveulcerativecolitis.Characteristiccollar-buttonorun
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