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目的探讨肠系膜静脉病变导致的缺血性肠病的临床及病理特征。方法对2003—2004年间收集到的肠系膜血管病变导致的缺血性肠病3例进行临床病理的系统分析。结果肠系膜静脉炎继发静脉血栓导致缺血性肠病,临床上以急性腹痛起病,可并发腹膜炎,急诊剖腹探查术中发现有坏死的病变肠段,切除后组织学检查在肠壁的黏膜下层和肠系膜的小到中等大小的静脉壁中有以淋巴细胞为主的炎细胞浸润,血管壁纤维素样坏死,血栓形成;但动脉未受累及。1例缺血性肠病在2年多的随访过程中没有局部的复发或发展成系统性的静脉炎。结论肠系膜静脉炎导致的缺血性肠病是一种罕见的疾病,是静脉的炎症病变,可逐渐导致血栓的形成,最后导致肠道的充血、缺血和坏死。该病可能有自限性,病变肠段的外科切除可以治愈。
Objective To investigate the clinical and pathological features of ischemic bowel disease caused by mesenteric vein disease. Methods Three cases of ischemic enteropathy caused by mesenteric vascular disease collected from 2003 to 2004 were analyzed systematically. Results Mesenteric phlebitis secondary to venous thrombosis leading to ischemic bowel disease, the clinical onset of acute abdominal pain, may be complicated by peritonitis, emergency laparotomy found necrotic lesions in the bowel, resection histology in the intestinal mucosa In the inferior and mesenteric small to medium sized venous walls have lymphocyte predominant inflammatory cell infiltration, vascular wall fibrosis, and thrombosis; but the arteries are not involved. One case of ischemic enteropathy had no local recurrence or developed systemic phlebitis over more than two years of follow-up. CONCLUSIONS: Mesenteric phlebitis causes ischemic enteropathy, a rare condition characterized by venous inflammatory changes that can gradually lead to thrombus formation and eventually to intestinal congestion, ischemia and necrosis. The disease may have self-limiting, surgical resection of bowel lesions can be cured.