【摘要】：目的探討阿米巴性結(jié)腸炎的臨床病理學(xué)特征、診斷及鑒別診斷。方法回顧性分析3例阿米巴性結(jié)腸炎的臨床表現(xiàn)、內(nèi)鏡和組織學(xué)特征,并復(fù)習(xí)文獻(xiàn)討論阿米巴性結(jié)腸炎的診斷和鑒別診斷。結(jié)果 3例患者均為男性,年齡27~35歲,臨床表現(xiàn)以急性感染癥狀腹痛、腹瀉為主。纖維結(jié)腸鏡下表現(xiàn)為腸黏膜的階段性糜爛和潰瘍,但病變部位不同。例1位于近闌尾孔處和直腸;例2位于橫結(jié)腸及直腸;例3位于回腸末端和直腸遠(yuǎn)端近肛門口。鏡下3例病變相似,在炎性壞死的腸黏膜面可見(jiàn)成片分布的大滋養(yǎng)體,滋養(yǎng)體內(nèi)可見(jiàn)核仁,胞質(zhì)內(nèi)見(jiàn)吞噬紅細(xì)胞現(xiàn)象。結(jié)論阿米巴性結(jié)腸炎是一種獨(dú)特的感染性腸病,纖維結(jié)腸鏡下無(wú)明顯特異性表現(xiàn),需與其他腸炎,尤其是慢性炎癥性腸病相鑒別,病理學(xué)檢查查見(jiàn)阿米巴滋養(yǎng)體是確定診斷的主要依據(jù)。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of amoebic colitis. Methods three cases of amoebic colitis were analyzed retrospectively, including their clinical manifestations, endoscopic and histological features, and the diagnosis and differential diagnosis of amoebic colitis were reviewed. Results all the 3 patients were male, aged 2735 years. The clinical manifestations were acute infection, abdominal pain and diarrhea. Fiberoptic colonoscopy showed periodic erosion and ulceration of intestinal mucosa, but the lesions were different. Case 1 was located near the appendix foramen and rectum; case 2 was located in transverse colon and rectum; case 3 was located at the distal end of ileum and proximal anal orifice of rectum. The pathological changes of 3 cases were similar under microscope. Large trophozoites, nucleolus and erythrocyte phagocytosis were observed in the inflammatory necrotic intestinal mucosa, nucleolus and erythrocyte in the trophoblast. Conclusion amoeba colitis is a unique infectious enteropathy with no specific manifestation under fiberoptic colonoscopy. It should be distinguished from other enteritis, especially chronic inflammatory enteropathy. Pathological examination of amoeba trophozoites is the main basis for diagnosis.
【作者單位】： 東南大學(xué)附屬中大醫(yī)院病理科;江蘇省中醫(yī)院病理科;
【分類號(hào)】：R531.11
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本文編號(hào)：2133015