结肠淀粉样变性的临床及内镜表现:3例报道并文献复习

Clinical and endoscopic features of colonic amyloidosis: three cases reports and literature review

探讨结肠淀粉样变性的内镜表现及临床特征。分析3例典型结肠淀粉样变性患者的结肠镜及临床表现,并总结国内外已发表的病例特点。结肠淀粉样变性可以分为两型。1型为非血管受累型,为最常见表现。其中黏膜下淤血、血泡、血肿和淤血吸收消散后溃疡形成为其特征性表现。2型累及黏膜下血管,其表现与缺血性肠病相似。便血和黏膜下血肿可能是结肠淀粉样变性的临床及特征性内镜表现,对于不明原因便血的患者,进行刚果红染色活检可以帮助早期诊断。

To investigate the endoscopic and clinical features of colonic amyloidosis.Characteristics of 3 cases of colonic amyloidosis were analyzed,compared with those published by previous authors.Colonic amyloidosis can be classified into two types.Type 1 is the commonest,and blood vessels are not involved.Typical endoscopic features include petechia,blebs,submucosal hematoma and the ensuing ulcer formation.Type 2 involves the blood vessels,and it resembles with that of ischemic colitis.Hematochezia and submucosal hematoma are the clinical and endoscopic features of colonic amyloidosis.For some patients with unknown hematochezia,congo red staining must be performed,which may be helpful for the early diagnosis and treatment.