Crohn氏病不典型临床表现(附6例误诊分析)

Unusual Clinical Manifestations of Crohn's Disease

为提高对Crohn病临床表现多样化的认识 ,本文介绍了 6例临床资料 ,其主要临床误诊情况为 :隐袭性不规则中、下腹痛被误诊为妇科疾患 ;长期排便不畅被误诊为习惯性便秘 ;发作性右下腹痛被误诊为阑尾炎 ;腹痛、腹泻与低热伴全身银屑病 ,吞咽痛被误诊为食道癌 ;腹痛、腹泻伴低热、脱发、闭经、皮肤红斑与肛门疾病等被误诊为红斑狼疮与溃疡性结肠炎 ;以及多被忽视的贫血与消瘦等。不典型临床表现的可能因素为 :⑴个体间免疫反应性的差异 ;⑵炎症侵犯部位不一 ;⑶有无局部或全身并发症 ;以及年龄及其它因素。重视不典型的腹痛与腹泻 ,以及被忽视的全身性表现 ,配合辅助检查 ,将有助于对不典型患者的及时诊断与发现。

Crohn's disease has various unusual clinical symptoms,thus its diagnosis is not easy,and it was often misdiagnosed as other diseases.In the paper,we described these unusual clinical symptoms from six cases of Crohn's disease,including irregular and mild inferior abdominal pain and watery diarrhea,low-grade fever,a change in bowel habits,weight loss,anemia,perianal disease,etc.The factors associated with the unusual clinical pattern possible are:⑴A difference existed in immune responsiveness to bowel inflammation among different indiviaduals;⑵Different segments involved;⑶With or without local and systemic complications;⑷The age of onset of the disease,and etc.By establishing a guideline for the recognition of patients with a complicated coures,a reliable diagnosis of CD can be successfully made.