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題名 | Chronic Phlebosclerotic Ischemic Colitis=靜脈硬化合併鈣化所引起之慢性缺血性大腸炎:病例報告 |
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作者 | 英恭史; 黃仁杰; 陳禮平; 吳新華; 張泰裕; 李宗憲; Ying, Kung-shih; Huang, Jen-chieh; Chan, Lai-ping; Wu, Shin-hwa; Chang, Tai-yu; Lee, Chung-hsein; |
期刊 | 中華放射線醫學雜誌 |
出版日期 | 20020600 |
卷期 | 27:3 2002.06[民91.06] |
頁次 | 頁129-134 |
分類號 | 416.245 |
語文 | eng |
關鍵詞 | 缺血性大腸炎; 大腸電腦斷層; 腸系膜血管; 靜脈狹窄或堵塞; Colitis ischemic; Colon CT; Veins mesenteric; Veins stenosis or obstruction; |
中文摘要 | 腸系膜靜脈硬化合併鈣化,是造成慢性缺血性大腸炎相當罕見的原因。我們報告一例因靜脈硬化合併鈣化所引起之慢性缺血性大腸炎。一位65歲女性,主訴右下腹疼痛,飯後腹漲,長達半年之久。特有的影像及檢查特徵如下:(1) 腹部放射線攝影-在升結腸及橫結腸可以看出血管性之鈣化,(2) 腹部電腦斷層-大腸壁增厚及鈣化,並有腸系膜靜脈鈣化,(3) 下消化道攝影-大腸腔室變窄,腸壁變硬及指壓紋之腸壁外觀,(4) 上腸系膜動脈血管攝影-大腸之小動脈及周緣動脈狹窄或阻塞,靜脈回流受阻,(5) 大腸鏡-腸黏膜水腫,黏膜下腔靜脈擴張。 |
英文摘要 | Phlebosclerosis of the mesenteric vein is a rare cause of ischemic colitis. The clinicopathologic find-ings of chronic phlebosclerotic ischemic colitis are different from conventional ischemic colitis. We report a case showing the following features: (1) plain abdominal radiography-vascular calcifications at the ascending colon and transverse colon, (2) abdominal computed tomography (CT) - colonic wall thickening with intramural calcification and mesenteric venous calcification, (3) barium enema-luminal narrowing, wall rigidity and thumbprinting appearance, (4) superior mesenteric angiography-decreased vascularity of right colon, narrowing or occlusion of the marginal arteries, disturbance of venous return, dilatation and tortuosity of the veins along the vasa recta, (5) colonscopy-dark purple-col-ored edematous mucosa and prominent submucosal veins, (6) colonscopic biopsy-marked fibrous thick-ening with hyalinization of mucosal venous wall, narrowing of the lumen but no thrombus. The pathognomonic hallmark for radiological diagnosis of chronic phlebosclerotic ischemic colitis is the vas-cular calcifications in the colonic wall and mesen-teric veins seen on plain abdominal radiography and abdominal CT. |
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