肠壁囊样积气症的诊断与治疗

Diagnosis and treatment of pneumatosis cystoides intestinalis

肠壁囊样积气症是一种罕见疾病,其特点是从食管至直肠的全部或部分胃肠道黏膜下或者浆膜下囊状气体积聚,临床主要累及部位是结肠和小肠,亦可发生于肠系膜、大网膜、肝胃韧带等其他部位。近年来,随着影像检查手段的更新,检出率较前有上升趋势。由于大多数患者无明显症状或者只有消化道非特异性症状,如腹胀腹痛、腹泻便血等,容易导致漏诊或误诊。少部分患者会合并腹膜炎甚至消化道穿孔。处理原则与普通急腹症有所区别,预后取决于该病严重程度及合并疾病。本文将针对这一疾病的流行病学特点、病因与发病机制、临床表现、诊断和治疗做一综述,以期有利于临床一线医生诊疗。

Pneumatosis cystoides intestinalis(PCI)is a rare disease,which is characterized by the accumulation of gas cysts located in the submucosa or subserosa of the gastrointestinal tract.It can occur in the whole or part of the gastrointestinal tract from the esophagus to the rectum,but clinically the main involved sites are the colon and small intestine.PCI can also appear in other sites such as mesentery,the greater omentum and the hepatogastric ligament.In recent years,with the renewal of imaging method,the detection rate of PCI has been on the rise.Most patients with PCI have no obvious symptoms or only non-specific symptoms of the digestive tract like abdominal distension,abdominal pain,diarrhea,hematochezia,etc.The atypical clinical symptoms of PCI can easily lead to missed diagnosis or misdiagnosis.A small amount of patients would have complications like peritonitis and even perforation of the digestive tract.The therapeutic principle for these patients is different from that for patients with acute abdomen.The prognosis of PCI depends on its severity and comorbidities.In this article,a literature review would be conducted on the epidemiological characteristics,etiology and pathogenesis,clinical manifestations,diagnosis and treatment of PCI,which might help clinical doctors with diagnosis and treatment of the disease.