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目的探讨肠系膜下动脉造影及纤维结肠镜检查对缺血性肠炎的病因诊断和诊断价值。方法对49例经结肠镜及活检明确诊断者,再行肠系膜下动脉造影以确定其病因,其中3例还加做肠系膜上动脉造影以判断全身疾病对该病有否影响。结果49例肠镜检查发现有不同程度的局部黏膜充血、水肿、接触性出血。活检结果:有炎性细胞浸润,黏膜下出血,水肿及多纤维素血栓和含铁血黄素沉着。病变均位于左半结肠。肠系膜下动脉造影发现,3例主干完全阻塞并有侧支循环形成,31例主干有不同程度狭窄,动脉床显影不满意。另15例肠系膜下动脉床不显影或显影不满意。3例主干完全阻塞者加作肠系膜上动脉造影,结果未发现任何异常。结论肠系膜下动脉造影及纤维结肠镜检查对缺血性肠炎的诊断和判明其病因有肯定作用。
Objective To investigate the diagnosis and diagnosis of ischemic enteritis caused by inferior mesenteric artery angiography and colonoscopy. Methods Forty-nine patients diagnosed by colonoscopy and biopsy were confirmed by angiography of inferior mesenteric artery in order to confirm their etiology. Three of them also made superior mesenteric artery angiography to determine whether systemic diseases had any effect on the disease. Results 49 cases of colonoscopy found varying degrees of local mucosal congestion, edema, contact bleeding. Biopsy results: inflammatory cell infiltration, submucosal hemorrhage, edema and multi-fibril thrombosis and hemosiderin. Lesions are located in the left colon. Sub-inferior mesenteric artery angiography found that 3 cases of complete obstruction and trunk collateral circulation formation, 31 cases of different degrees of the main stenosis, arterial bed imaging are not satisfied. Another 15 cases of inferior mesenteric artery bed imaging or imaging are not satisfied. Three cases of total obstruction plus trunk mesenteric artery angiography, the results did not find any abnormalities. Conclusion The diagnosis of inferior mesenteric artery angiography and colonoscopy for the diagnosis of ischemic enteritis and its etiology have a positive effect.