溃疡性结肠炎相关全小肠炎3例报道并文献复习

Ulcerative colitis related pan enteritis:three cases report and literature review

目的总结溃疡性结肠炎(UC)相关全小肠炎的临床特征。方法回顾性总结2018年1月至2019年5月中山大学附属第六医院和浙江大学医学院附属邵逸夫医院收治的3例UC相关全小肠炎的临床特征及诊治过程,并以“ulcerative colitis”、“pan enteritis”、“enteritis”、“溃疡性结肠炎”、“小肠炎”为检索词,检索PubMed、Web of Science、Embase、中国知网、万方数据库自2004年1月至2019年5月的文献,进行相关文献复习总结。结果纳入3个病例均为UC患者,分别在结肠切除术后14 d、10 d和2个月出现了腹痛、呕血、造口排量增大、造口排血性液体等症状,经过影像学、内镜、病理检查后诊断为UC结肠切除术后全小肠炎,其中1例激素治疗后死亡,1例激素治疗后好转,1例激素治疗无效转换英夫利西单克隆抗体后好转。共检索到9篇UC相关小肠炎的报道。结论UC相关全小肠炎多发生在结肠切除术后,属于临床急重症,早诊早治尤其重要。

Objective To summarize the clinical features of ulcerative colitis related pan enteritis.Methods Clinical course of diagnosis and treatment of three cases of ulcerative colitis related pan enteritis at The Sixth Affiliated Hospital of Sun Yat sen University and Sir Run Run Shaw Hospital of Zhejiang University School of Medicine were retrospectively reviewed.Key words of"ulcerative colitis","pan enteritis","enteritis"were used to retrieve associated literatures from PubMed,Web of Science,Embase,China Knowledge Network and Wanfang database from January 2004 to May 2019.Related literatures were also reviewed.Results Three patients diagnosed as UC were admitted to hospital with abdominal pain,haematemesis,high ileostomy output,ileostomy bloody output 14 days,10 days and 2 months after colectomy.All the patients were diagnosed with ulcerative colitis related pan enteritis confirmed by endoscopy,imaging examination and pathology.One patient died after steroids therapy and the other two patients were recovered after steroids and infliximab therapy respectively.A total of 9 studies about ulcerative colitis related pan enteritis were included.Conclusions Ulcerative colitis related pan enteritis is an emergency and critical disease.Early diagnosis and treatment are crucial in the therapeutic process.