1～6月龄婴儿食物过敏致下消化道出血结肠镜及病理特点分析

Analysis of characteristics and colonoscopy on baby with lower gastrointestinal bleeding caused by food allergy

目的探讨食物过敏所致下消化道出血患儿电子结肠镜和肠黏膜病理改变的特点,总结婴儿下消化道出血的诊治经验。方法对郑州大学第三附属医院小儿消化科收住院的16例下消化道出血患儿的临床资料进行回顾性总结分析。结果 13例(81.3%)发现有灶性红斑、局部黏膜水肿、易脆;11例(68.8%)发现有黏膜疣状隆起,部分伴有小糜烂面;1例(6.3%)发现有溃疡。部位以直肠、乙状结肠为多,共10例(62.5%),降结肠2例(12.5%),横结肠1例(6。25%)。组织病理学检查皆显示慢性非特异性炎症改变;其中8例(50.0%)伴有较多嗜酸粒细胞浸润。食物回避3月后复查,结肠黏膜基本恢复正常,组织病理均表现为慢性非特异性炎性改变。结论食物过敏所致下消化道出血患儿电子结肠镜检查具有一定特征性,对诊断有一定帮助,组织病理检查发现嗜酸粒细胞性浸润对诊断有重要帮助。

Objective To investigate the electronic colonoscopy and the characteristics of intestinal mucosa pathological changes of lower gastrointestinal bleeding caused by food allergy and summarize the experience of diagnosis and treatment of lower gastrointestinal bleeding of baby. Methods The third affiliated hospital of Zhengzhou university, department of pediatric digestion, analyze the clinical data of 16 cases of lower gastrointestinal bleeding. Results Totally 13 cases （81.3%） were found focal erythema, local mueosa edema, brittle; 11 cases （68. 8% ） were found mucosal verrueous uplift, part of them with little erosion surface; 1 ease （6. 3% ） was found ulcers. The part of lesion： 10 eases （62. 5% ） were found in rectum and sigmoid colon, 2 cases of colon （ 12. 5% ）, transverse colon in 1 case （6. 25% ）. Histopathologic examination showed chronic nonspecific inflammatory change; 8 patients （50. 0% ） with more acidophilic granulocyte infiltration. To avoid food for 3 months, basically returned to normal, colon mucosa tissue pathology were characterized by chronic nonspeeific inflammatory change. Conclusion The lower gastrointestinal bleeding eansed by food allergy under the electronic colonoseopy has certain characteristic. , it＇s helpful to the diagnosis. Histopathologic examination revealed acidophilie granulocyte infiltration have important help to the diagnosis.