论文部分内容阅读
结肠转移癌,在罕见的情况下可以与结肠炎性病变相似。以前已有两个作者报告了结肠的转移导致了与克隆氏病相混淆的病例。本文作者报告了1例结肠浸润型转移癌误诊为克隆氏病的病例。病人为一男性,38岁。因右下肢深静脉血栓入院,有体重减轻和间歇性腹泻的病史。钡灌肠见升结肠近端内侧结肠袋消失,粘膜表面不规则呈刺状。降结肠远端内侧有同样改变,乙状结肠系膜附着侧呈粗糙的鹅卵石状,对侧有表浅性横行溃疡,结肠袋消失,乙状结肠腔狭窄。结肠镜见结肠袋消失,有节段性、环形肿胀而发红的粘膜皱襞,呈典型的鹅卵石形态。钡灌肠和内窥镜均诊断为克隆氏病。但组织学及尸检证明为结肠转移癌。
Metastatic carcinoma of the colon, in rare cases, can be similar to colonic inflammatory lesions. Two authors have previously reported that colonic metastases result in cases that are confused with Crohn’s disease. The authors report a case of colon invaded metastatic carcinoma misdiagnosed as Crohn’s disease. The patient is a man, 38 years old. There was a history of weight loss and intermittent diarrhea due to admission to the hospital with deep vein thrombosis of the right lower extremity. Barium enema shows that the proximal colon of the ascending colon disappears and the surface of the mucosa is irregular. The distal descending colon has the same changes in the distal medial side of the sigmoid mesentery with a rough cobblestone-like, contralateral superficial transverse ulcer, colon bag disappeared, sigmoid colon narrow. The colonoscope showed that the colon bag disappeared, with segmental, ring-shaped swelling and reddening mucosal folds, showing a typical cobblestone morphology. Barium enema and endoscopy were diagnosed as Crohn’s disease. However, histology and autopsy proved colon cancer.