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肠道准备后不但不解便，直肠还出现N多小白点——案例报道

2016-09-17 Mechront 译 MedSci原创

磷酸钠结肠镜腹痛
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患者女，35岁，结肠镜体检，服用磷酸钠溶液进行肠道准备，但是结肠准备前后，患者没有腹痛，也没有解大便。 查体也没有发现什么特别的。实验室检查：血红蛋白 16.3 g/dL，白细胞计数 8140/μL，血小板计数 225,000/μL。 结肠镜（A、B）：直肠粘膜可见多发大小约2-3mm的白色斑点，伴红色边缘。放大内镜检查结果如图C。 白色粘膜活

患者女，35岁，结肠镜体检，服用磷酸钠溶液进行肠道准备，但是结肠准备前后，患者没有腹痛，也没有解大便。

查体也没有发现什么特别的。实验室检查：血红蛋白 16.3 g/dL，白细胞计数 8140/μL，血小板计数 225,000/μL。


结肠镜（A、B）：直肠粘膜可见多发大小约2-3mm的白色斑点，伴红色边缘。放大内镜检查结果如图C。

白色粘膜活检（D、E）：固有层被淋巴集结侵蚀。红色边缘是因为固有层出血。



诊断：结肠口疮样病变，与口服磷酸钠相关。

口服磷酸钠已被越来越多地用于结肠准备，因为它能有效的对肠道进行清洁，并且患者的耐受性良好，接受度高。大约有3.3%的患者会出现磷酸钠相关的结肠粘膜异常（包括口疮病灶、糜烂和溃疡），病变通常位于直肠和乙状结肠远端。

本案例患者的内镜下病变看着像溃疡，但是放大内镜没有发现白色部分不是溃疡，组织学也正是了淋巴聚集，所以诊断为结肠口疮样病变。

原始出处：

Ming-Hung Hsu,et al.White Spots in the Rectum.Gastroenterology.September 2016Volume 151, Issue 3, Pages e15–e16

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    2016-09-23 187清风

    继续努力

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    2016-09-23 187清风

    要有不放松的眼光

    0

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    2016-09-23 187清风

    厉害，学习了

    0

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    2016-09-23 187清风

    继续学习

    0

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    2016-09-18 wjcjjian

    #肠道准备#

    0

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    2016-09-18 夫夫子

    学习了，还没想碰到过这样的病号！

    0

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    2016-09-18 1dd8a7c5m95(暂无匿称)

    学习了，赞一个！！！

    0

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    2016-09-18 流氓豆豆

    很好的病例，学习了

    0

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    2016-09-18 摩天轮

    很好的病例报道

    0

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    2016-09-17 lhl629

    很好的内容，谢谢分享。

    0

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