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1.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(10): 1109-1113, 2021 Oct 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34911841

RESUMO

OBJECTIVES: At present, there are many studies on Crohn's disease of terminal ileum and colon, but few studies on Crohn's disease of small intestine alone. This study aims to analyze the clinical features and therapeutic effect of small bowel in adult patients with Crohn's disease so as to strengthen the diagnosis and treatment for this disease. METHODS: From July 1, 2015 to October 31, 2018, patients with small bowel Crohn's disease at Department of Gastroenterology, Third Xiangya Hospital of Central South University, were enrolled. At the same time, patients' demographics and clinical data were collected. RESULTS: A total of 44 patients were small bowel Crohn's disease. Among them, 40 patients were male. The age at diagnosis was (35.8±10.3) years old and disease duration was (35.2±59.5) months. The subtypes included 29(65.9%) of ileum, 7(15.9%) of jejunum, 8(18.2%) of ileum with jejunum. There were 27(61.4%) of stricture behavior, 4(9.1%) of penetrating behavior, and 13(29.5%) of non-stricture and non-penetrating behavior. Endoscopic visible stricture (29/85, 34.1%) was common, followed by longitudinal ulcers (27/85, 31.8%). Non-caseate granulomatous were found in 2 cases (4.5%). The score of Crohn's disease activity index was correlated to hemoglobin, hematocrit, and erythrocyte sedimentation rate (all P<0.05). Among the most common symptom of abdominal pain (34/44, 77.3%), 11 patients (25.0%) developed complications (eg. intestinal obstruction) during the follow-up, and 66.7% of patients treated with mesalazine had complications. CONCLUSIONS: Patients with ileum account for a large proportion in patients with small bowel Crohn's disease. Stricture is more common in small bowel Crohn's disease. Stricture and longitudinal ulcer are more common under enteroscopy. Crohn's disease activity index is correlated to hemoglobin, red blood cell specific volume, and erythrocyte sedimentation rate. The most common complication is intestinal obstruction. Mesalazine is less effective on small bowel Crohn's disease.


Assuntos
Doença de Crohn , Obstrução Intestinal , Adulto , Doença de Crohn/tratamento farmacológico , Endoscopia Gastrointestinal , Humanos , Íleo , Obstrução Intestinal/etiologia , Intestino Delgado , Masculino , Pessoa de Meia-Idade
2.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(11): 1310-1314, 2021 Nov 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34911868

RESUMO

Inflammatory myofibroblastoma (IMT) is a rare solid tumor, and its etiology and pathogenesis are unclear. Crohn's disease is a non-specific intestinal inflammatory disease. The clinical manifestations, laboratory examinations, and imaging examinations of IMT are not specific, making diagnosis difficult. A case of Crohn's disease combined with IMT of abdominal wall was admitted to the Department of Gastroenterology at the Third Xiangya Hospital, Central South University, on Nov. 21, 2017. This patient was admitted to our hospital because of repeated right lower abdominal pain for 4 years. A 6 cm×5 cm mass was palpated in the right lower abdomen. After completing the transanal double-balloon enteroscopy and computed tomographic enterography for the small intestinal, the cause was still unidentified. The patient underwent surgery due to an abdominal wall mass with intestinal fistula on Sept. 12, 2018 and recovered well currently. According to histopathology and immunohistochemistry, he was diagnosed with Crohn's disease combined with IMT. Up to July 2020, the patients still took azathioprine regularly, without abdominal pain, abdominal distension, and other discomfort, and the quality of his life was good.


Assuntos
Parede Abdominal , Doença de Crohn , Neoplasias de Tecido Muscular , Dor Abdominal , Parede Abdominal/cirurgia , Doença de Crohn/complicações , Humanos , Intestino Delgado , Masculino , Neoplasias de Tecido Muscular/complicações , Neoplasias de Tecido Muscular/diagnóstico por imagem , Neoplasias de Tecido Muscular/cirurgia
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(12): 1447-1450, 2021 Dec 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-35232918

RESUMO

Severe ulcerative colitis is usually severe and rapidly progressive, with a particularly high risk of life-threatening complications and colectomy. For ulcerative colitis, surgical treatment may be considered when medical treatment fails. A case of severe ulcerative colitis failed to be treated with conventional drugs, resulting in complications such as hypotension shock, which met the indication of surgery. Since the patient was a young unmarried female, there were risks of life quality, sexual dysfunction, and infertility after surgery. Therefore, after analyzing the reasons for the poor curative effect of internal medicine, taking standardized treatment schemes, fully enhancing nutritional support, regulation of intestinal microecology, and other individualized treatments were taken. The patients changed from severe to mild. It is suggested that nutritional support is as important as drug therapy in ulcerative colitis.


Assuntos
Colite Ulcerativa , Colectomia/métodos , Colite Ulcerativa/cirurgia , Feminino , Humanos
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