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目的探讨食物过敏所致下消化道出血患儿电子结肠镜和肠黏膜病理改变的特点,总结婴儿下消化道出血的诊治经验。方法对郑州大学第三附属医院小儿消化科收住院的16例下消化道出血患儿的临床资料进行回顾性总结分析。结果 13例(81.3%)发现有灶性红斑、局部黏膜水肿、易脆;11例(68.8%)发现有黏膜疣状隆起,部分伴有小糜烂面;1例(6.3%)发现有溃疡。部位以直肠、乙状结肠为多,共10例(62.5%),降结肠2例(12.5%),横结肠1例(6。25%)。组织病理学检查皆显示慢性非特异性炎症改变;其中8例(50.0%)伴有较多嗜酸粒细胞浸润。食物回避3月后复查,结肠黏膜基本恢复正常,组织病理均表现为慢性非特异性炎性改变。结论食物过敏所致下消化道出血患儿电子结肠镜检查具有一定特征性,对诊断有一定帮助,组织病理检查发现嗜酸粒细胞性浸润对诊断有重要帮助。
Objective To investigate the pathological changes of electronic colonoscopy and intestinal mucosa in children with gastrointestinal bleeding caused by food allergy and to summarize the diagnosis and treatment of infantile lower gastrointestinal bleeding. Methods The clinical data of 16 cases of children with lower gastrointestinal bleeding admitted to the Third Affiliated Hospital of Zhengzhou University were analyzed retrospectively. Results Erythema was found in 13 cases (81.3%) with local mucosal edema and brittleness. In 11 cases (68.8%), mucosal swelling was found, with small erosive surface in some cases. Ulcers were found in 1 case (6.3%). The sites were mostly rectum and sigmoid colon, with a total of 10 cases (62.5%), 2 descending colon (12.5%) and 1 transverse colon (6.25%). Histopathological examination showed chronic non-specific inflammatory changes; 8 (50.0%) with more eosinophilic infiltration. Food avoidance review after 3 months, colon mucosa returned to normal, histopathology showed chronic non-specific inflammatory changes. Conclusion Electronic colonoscopy in children with alimentary tract hemorrhage caused by food allergy has certain characteristic, which is helpful to diagnosis. Histopathological examination found that eosinophil infiltration is of great help in the diagnosis.