以下消化道大出血为首发症状的克罗恩病的诊断和治疗

The diagnosis and treatment of Crohn disease showing acute lower gastrointestinal massive hemorrhage(report of 1 case)

目的探讨以下消化道大出血为首发症状的克罗恩病的诊断和治疗。方法回顾性分析1例该病患者的临床资料,并对相关文献进行复习和总结。结果采取输血和支持疗法,静脉输注生长抑素,稳定生命体征后,行电子结肠镜及病理组织学检查,明确诊断为克罗恩病。用皮质激素和柳氮磺胺吡啶治疗后痊愈出院。结论当下消化道大出血作为克罗恩病的首发症状,而肠道症状很不典型或缺乏时,结肠镜检查有重要价值。生长抑素有利于止血,皮质激素和柳氮磺胺吡啶仍为治疗克罗恩病的主要药物。

Objective To investigate the strategy in the diagnosis and treatment of Crohn disease that represents lower gastrointestinal tract massive hemorrhage as the first symptom. Methods A case of Crohn disease successfully diagnosed and treated was reported here, with the pertinent literature reviewed. Results Blood transfusion and supportive therapy with somatostatin iv gt were administered. When the vital signs were stabilized, electronic colonoscopy and histopathologic examination were performed to establish the final diagnosis of Crohn disease. Following a course of standard adrenocortical hormone and SASP therapy, the patient fully recovered from illness. Conclusion Coloscopy is valuable for diagnosing the Crohn disease that represents massive hemorrhage of lower gastrointestinal tract as the first symptom, especially in case the intestinal symptoms are lacking or atypical. Somatostatin is effective for treating alimentary tract hemorrhage, but adrenocortical hormone and SASP are still the principal medicines for Cohn disease.