Analysis on the Clinical Characteristics of Crohn’s Disease and the Reasons for Its Misdiagnosis_West China Medical Journal

Authors：

CHENG Lina ¹ , LI Xueqin ² , WANG Xiuqi ¹ ,  GAN Huatian ³

1. Department of Gastroenterology, Henan Provincial People’s Hospital, Zhengzhou, Henan 450003, P. R. China; 2. Department of Internal Medicine People’s Hospital of Pengshan city, Meishan, Sichuan 614000, P. R. China; 3. Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

GAN Huatian, Email: chenglina1983@yahoo.cn

Keywords：

克羅恩病; 回顧性分析; 誤診

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目的　分析克羅恩病的臨床特點、內鏡表現、病理特點、誤診原因，為克羅恩病的診治提供臨床經驗。方法　回顧性分析河南省人民醫院2004年1月－2011年12月38例克羅恩病臨床特點，并對誤診情況及原因進行分析。結果　38例小腸克羅恩病患者，癥狀主要表現為腹痛、腹瀉及便血。病變多位于末端回腸和回盲部，最常見的并發癥為腸梗阻。結腸鏡下可見節段性黏膜充血水腫、鋪路石樣改變、多發不規則潰瘍；病理示全壁性炎癥、深裂隙狀縱行潰瘍及非干酪性肉芽腫。克羅恩病的診斷主要依靠內鏡及病理。結論　克羅恩病臨床表現復雜多樣，臨床誤診、漏診情況較為多見，需進一步提高對克羅恩病的認識。

Citation： CHENG Lina,LI Xueqin,WANG Xiuqi,GAN Huatian. Analysis on the Clinical Characteristics of Crohn’s Disease and the Reasons for Its Misdiagnosis. West China Medical Journal, 2012, 27(9): 1322-1324. doi: Copy

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1. 　中華醫學會消化病學分會炎癥性腸病協作組. 對我國炎癥性腸病診斷治療規范的共識意見[J]. 胃腸病學, 2007, 12(8): 488-495.
2. 　歐陽欽，Tandon R，Goh KL，等. 亞太地區炎癥性腸病處理共識意見[J]. 胃腸病學, 2006, 11(4): 233-237.
3. 　徐富星, 岑戎. 炎癥性腸病結腸鏡檢查的評價[J]. 中華消化雜志, 2001, 21(4): 199-200.
4. 　Marshall JK, Cawdron R, Zealhy I, et a1. Prospective comparison of small bowel meal with pneumocolon versus ileo-colonoscopy diagnosis disease[J]. Am J Gastroenterol, 2004, 99(7): 1321-1329.
5. 　Kirsch R, Pentecost M, Hall Pde M, et a1. Role of colonoscopic biopsy in distinguishing between Crohn’s disease and intestinal tuberculosis[J]. J Clin Pathol, 2006, 59(8): 840-844.
6. 　鄭家駒, 史肖華, 褚行琦, 等. 克羅恩病的臨床多樣性[J]. 中華消化雜志, 2002, 22(4): 226-229.
7. 　甘華田, 歐陽欽, 邱春花. 內鏡活組織檢查對克羅恩病的診斷價值[J]. 中華消化內鏡雜志, 2001, 18(2): 103-104.
8. 　Pineton de Chambrun G, Peyrin-Biroulet L, Lémann M, et a1. Clinical implications of mucosal healing for the management of IBD[J]. Nat Rev Gastroenterol Hepatol, 2010, 7(1): 15-29.
9. 　鄭家駒, 史肖華, 褚行琦, 等. 克羅恩病臨床特征以及診斷和治療選擇[J]. 中華內科雜志, 2002, 41(9): 581-585.
10. 　Rutgeerts P, Feagan BG, Lichtenstein GR, et a1. Comparison of scheduled and episodic treatment strategies of infliximab in Crohn’s disease[J]. Gastroenterology, 2004, 126(2): 402-413.
11. 　Podolsky DK. Inflammatory bowel disease[J]. N Engl J Med, 2002, 347(6): 417-429.
12. 　Mowat C, Cole A, Windsor A, et a1. Guidelines for the management of inflammatory bowel disease in adults[J]. Gut, 2011, 60(5): 571-607.

West China Medical Journal

Analysis on the Clinical Characteristics of Crohn’s Disease and the Reasons for Its Misdiagnosis

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