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：

克罗恩病; 回顾性分析; 误诊

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目的　分析克罗恩病的临床特点、内镜表现、病理特点、误诊原因，为克罗恩病的诊治提供临床经验。方法　回顾性分析河南省人民医院2004年1月－2011年12月38例克罗恩病临床特点，并对误诊情况及原因进行分析。结果　38例小肠克罗恩病患者，症状主要表现为腹痛、腹泻及便血。病变多位于末端回肠和回盲部，最常见的并发症为肠梗阻。结肠镜下可见节段性黏膜充血水肿、铺路石样改变、多发不规则溃疡；病理示全壁性炎症、深裂隙状纵行溃疡及非干酪性肉芽肿。克罗恩病的诊断主要依靠内镜及病理。结论　克罗恩病临床表现复杂多样，临床误诊、漏诊情况较为多见，需进一步提高对克罗恩病的认识。

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. 　中华医学会消化病学分会炎症性肠病协作组. 对我国炎症性肠病诊断治疗规范的共识意见[J]. 胃肠病学, 2007, 12(8): 488-495.
2. 　欧阳钦，Tandon R，Goh KL，等. 亚太地区炎症性肠病处理共识意见[J]. 胃肠病学, 2006, 11(4): 233-237.
3. 　徐富星, 岑戎. 炎症性肠病结肠镜检查的评价[J]. 中华消化杂志, 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. 　郑家驹, 史肖华, 褚行琦, 等. 克罗恩病的临床多样性[J]. 中华消化杂志, 2002, 22(4): 226-229.
7. 　甘华田, 欧阳钦, 邱春花. 内镜活组织检查对克罗恩病的诊断价值[J]. 中华消化内镜杂志, 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. 　郑家驹, 史肖华, 褚行琦, 等. 克罗恩病临床特征以及诊断和治疗选择[J]. 中华内科杂志, 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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