一例克罗恩病病例分析
Patient female, 37 year(s)
患者女性，37岁
CLINICAL HISTORY
临床病史
Chronic abdominal pain and altered bowel habits.
慢性腹痛及排便习惯改变。
IMAGING FINDINGS
成像发现
Multiple areas of small bowel thickening with intervening skip areas. Few long segment areas of small bowel thickening, mesenteric vascular engorgement with multiple enlarged mesenteric lymph nodes.
小肠多个区域增厚及跳跃区域干预。小肠部分较长的肠段增厚，肠系膜血管充血伴有多发性肠系膜淋巴结肿大。
Figure 1（图一）
Arrow shows a segmental thickened bowel loop.
箭头所指表示节段性肠管增厚。
Figure 2 图二
Arrows show thickened bowel loops.
箭头所指表示肠管增厚。
Figure 3 图三
Arrows show thickened bowel loops and enlarged mesenteric lymph nodes.
箭头所指表示肠管增厚和肠系膜淋巴结肿大。
Figure 4 图四
Arrows showing enlarged mesenteric lymph nodes.
箭头所指表示肠系膜淋巴结肿大。
Figure 5 图五
Arrows show another thickened bowel loop.
箭头所指表示另一个肠管增厚。
Figure 6 图六
Large arrows show mesenteric vascular engorgement and the small arrow shows a thickened bowel loop.
大箭头所指表示肠系膜血管充血，小箭头表示增厚的肠袢。
Figure 7 图七
Arrows show long segment thickening of a bowel loop.
箭头所指表示肠管长节段增厚。
DISCUSSION
讨论
In a patient who presents with a chronic history of abdominal pain and altered bowel habits, inflammatory bowel disease should be a consideration.
在一位表现有慢性腹痛病史和排便习惯改变的患者中，应考虑炎性肠炎。
A CE CT abdomen is the investigation of choice in such cases.
在这种案例中，慢性子宫内膜炎（CE）腹部CT可作为一个研究选项。
In the above case there were multiple areas of small bowel thickening with skip areas, few long segment small bowel thickenings, mesenteric vascular engorgement and enlarged mesenteric lymph nodes .
在上文的例子中有小肠多个区域增厚及新生区域干预，小肠部分较长的肠段增厚，肠系膜血管充血伴有多发性肠系膜淋巴结肿大。
All these findings favour the diagnosis of inflammatory bowel disease, most likely Crohn's.The differentials under consideration were ulcerative colitis and tuberculosis.
所有这些发现支持了炎性肠病的诊断，最可能是克罗恩病。不同的观点有溃疡性结肠炎和结核病。
In ulcerative colitis there is continuous involvement of the bowel without any skip areas starting from the rectum and proceeding proximally.
在溃疡性结肠炎中，持续累及小肠但无任何新生区域，开始于直肠和周围临近部分。
In tuberculosis there is predominant involvement of the caecum and ileocaecal junction and necrotic, caseous lymphadenopathy. Skip areas and mesenteric vascular engorgement are absent.
在结核病中，明显累及盲肠与回盲部交接处并有坏死和干酪样淋巴结病。 不存在新生区域和肠系膜血管充血。
FINAL DIAGNOSIS
最终诊断
Crohn's disease
克罗恩病
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焦点事件
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科技前沿
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科技前沿
