克罗恩病的穿透形式。诊断困难及术前规划(临床病例)

M. Y. Belikovа, T. L. Gorshenin, I. K. Borovik, Yu. A. Sizov
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引用次数: 0

摘要

目的:探讨穿透性克罗恩病与肠恶性肿瘤鉴别诊断的困难。患者和方法:一个临床病例的患者的年龄较大的群体与穿透变异克罗恩病的发作是提出的。结果:入院当天急诊检查,患者右侧髂区腹部肿块,累及肠壁、前腹壁,并发急性肠梗阻。初步诊断:结肠肿瘤合并炎症及急性肠梗阻。患者的病情和两个危及生命的并发症需要紧急手术干预-扩大右侧半结肠切除术。最初的组织学检查也不允许我们排除肿瘤的性质,但免疫组织化学分析的第二次组织学修订使克罗恩病的诊断成为可能。结论:克罗恩病可以出现在任何年龄,包括复杂的形式。这就要求在鉴别肠恶性肿瘤时,特别是当病变位于右髂区时,要包括这种病理。这将有助于优化手术入路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Crohn’s disease penetrating form. Difficulties of diagnostics and preoperative planning (clinical case)
AIM: to demonstrate the difficulties of differential diagnosis of the penetrating variant of Crohn’s disease and malignant neoplasm of the intestine.PATIENTS AND METHODS: a clinical case of a patient of an older age group with the onset of a penetrating variant of Crohn’s disease is presented.RESULTS: according to the results of an urgent check-up on the day of admission, the patient had an abdominal mass in the right iliac region, involving the intestinal wall, anterior abdominal wall, complicated by acute intestinal obstruction. Preliminary diagnosis: colon tumor complicated by inflammation and acute intestinal obstruction. The patient’s condition and two life-threatening complications required an urgent surgical intervention — extended right-sided hemicolectomy. The primary histological examination also did not allow us to exclude the tumor nature, but a second revision of histology with immunohistochemical analysis made it possible to establish the diagnosis of Crohn’s disease.CONCLUSION: Crohn’s disease can debut at any age, including complicated forms. This requires the inclusion of this pathology in the differential diagnosis with malignant neoplasms of the intestine, especially when the changes are located in the right iliac region. This will help to optimize the surgical approach.
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