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直肠阿米巴瘤较少见,国内报导不多,本院肠道门诊曾遇到一例,报告如下:患者孙××,门诊号831395,男性,50岁.安徽涡阳人.低热腹胀,脐上位伴轻度腹痛2月余,乏力,纳差,进行性消瘦半月余.大便每天7～8次,多则十余次,有里急后重感,在当地按菌痢治疗,病情反渐加重,拟诊“直肠癌”于198年8月14日来我院诊治,初诊时其体温37℃,心率90次,BP 100/70,轻度贫血面容,恶液质,心肺听诊(-),腹软,肝脾未触及,左下腹轻度压痛.大便镜检有红白血球及脓球,未找到阿米巴.肛门指检可触及一花生米大小之赘生物,有触痛及出血.乙状结肠镜检查,取胸肋位,距肛门7～8cm于2～6点处有铜钱大小赘生物呈溃疡型,触之出血.取直肠粘膜活检,病理检查(病理号835652)为直肠阿米巴瘤.8月20日开始抗阿米巴和抗菌治疗(灭滴度0.4/次,3次/日,庆大霉素4万μ/次,4次/日)以及对症处理,病情迅速好转,3天后大便次数减少,2～3天,腹痛消失,10天后大便基本正常,乙状结肠镜检查,肠腔溃疡消失,肠粘膜稍粗糙外其余无特殊.
Rectal anemia is relatively rare, not many domestic reports, our hospital has encountered a case of intestinal gout, the report is as follows: Patient Sun × ×, outpatient number 831395, male, 50 years old. Superior with mild abdominal pain more than 2 months, fatigue, anorexia, progressive thinning more than half a month stool 7 to 8 times a day, as many as more than ten times, a tenesmus heavy sense, according to the local treatment of bacillary dysentery, the disease gradually increased, the proposed increase The diagnosis of “rectal cancer” came to our hospital on August 14, 1988. The body temperature was 37 ℃, heart rate 90 times, BP 100/70, mild anemia, cachexia, cardiopulmonary auscultation (-), abdomen soft , Liver and spleen not touched, mild left lower quadrant tenderness stool examination of red and white blood cells and pus ball, did not find amoeba.Animal finger examination can reach a peanut-sized vegetation, tenderness and bleeding .Sigmoidoscopy , Take the thoracic rib, from the anus 7 ~ 8cm at 2 to 6 points at the size of a copper coin was ulcer-like vegetation, touch the bleeding .Rectal mucosal biopsy, pathological examination (pathological number 835652) rectal amoeba .8 On the 20th, anti-amoebic and antibacterial treatment started (anti-infective rate of 0.4 / time, 3 times / day, gentamicin 40,000 / time, 4 times / day) and symptomatic treatment. Times Reduction, 2 to 3 days, abdominal pain, normal stool after 10 days, sigmoidoscopy, disappeared intestine ulcers, intestinal slightly rough outer no special rest.