类风湿血管炎伴多发性肠道溃疡1例报告

Ryumachi. [Rheumatism] Pub Date : 2000-06-01
K Takeuchi, Y Kuroda
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引用次数: 0

摘要

类风湿性血管炎是类风湿性关节炎(RA)的一种相对少见的并发症。它表现为广泛的关节外特征,包括皮肤和神经受累,但很少表现为胃肠道受累。我们描述一个79岁的老人类风湿血管炎表现为小肠多发性溃疡,并伴有降结肠憩室穿孔。患者因直肠出血和严重贫血入院。他患有类风湿关节炎超过10年,接受非甾体抗炎药(NSAIDs)和低剂量强的松治疗。上镜或结肠镜检查未见出血迹象。他突然出现腹痛,并进行了紧急手术。切除降结肠和小肠,发现降憩室穿孔和严重的小肠多发溃疡。病理检查显示小肠多发溃疡,由血管炎引起。
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[Rheumatoid vasculitis with multiple intestinal ulcerations: report of a case].

Rheumatoid vasculitis is a relatively uncommon complication of rheumatoid arthritis (RA). It shows wide variety of extra-articular features including skin and neurologic involvement, but rarely shows gastrointestinal involvement. We describe a 79-old-man of rheumatoid vasculitis manifesting as small bowel multiple ulcerations accompanied by perforation of the descending colon diverticulum. The patient was admitted to our hospital with rectal bleeding and severe anemia. He had had rheumatoid arthritis for more than 10 years with treatment of non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose prednisone. Upper endoscopy or colonoscopy revealed no evidence of bleeding. Suddenly he developed cramping abdominal pain, and emergency operation was performed. Segments of the descending colon and small bowel were resected to reveal perforation of the descending diverticulum and severe multiple ulcer of small bowel. The pathological examination showed multiple ulcerations of the small intestine was caused by vasculitis.

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