溃疡性结肠炎的诊断与治疗课件.ppt

溃疡性结肠炎的诊断与治疗溃疡性结肠炎的诊断与治疗溃疡性结肠炎的诊断与治疗

溃疡性结肠炎的诊断与治疗临床症状常见：腹痛、发热(38?C)、腹泻、血便、 消瘦。肠外表现：关节炎、口腔溃疡、强直性脊柱 炎（HLA-B27）、微型硬化性胆 管炎。溃疡性结肠炎的诊断与治疗内镜检查及X线检查内镜检查表现：中毒性巨结肠是内镜绝对 禁忌症钡剂灌肠：铅管征、毛刺样改变、粘膜颗 粒粗糙溃疡性结肠炎的诊断与治疗Endoscopicfeaturesofactiveulcerativecolitis

Figure4-1.Endoscopicfeaturesofactiveulcerativecolitis.Findingsincludediffuselyerythematous,edematous,andgranularmucosawithareasofsubmucosalhemorrhageand,whensevere,frankmucopurulentexudate.Inflammationinvariablybeginsintherectumandextendsproximallyforvaryingextents.Thechronicityoftheprocessissuggestedbythelossofcolonichaustrations;otherwise,theendoscopicpictureisnonspecificandcouldbeconsistentwithacuteinfectiouscolitis,chroniculcerativeorCrohn`scolitis,oranynumberofotherspecificcausesofcolitis.A,Milddistalulcerativecolitiswithdiffuseerythemaandfriabilitywelldemarcatedfromthenormalmucosamoreproximallyisdepicted.B,Thisexampleshowsmoderatelysevereulcerativecolitiswithirregular,inflamed,ulceratedmucosaandapatchyexudate.溃疡性结肠炎的诊断与治疗Ulcerativecolitisinremission

Figure4-2.Ulcerativecolitisinremission.Thenormalvascularpatternisabsentandawhitescarindicatesthesiteofapreviousulcer.

溃疡性结肠炎的诊断与治疗Severeulcerativecolitis

Figure4-3.Severeulcerativecolitis.Themucosashowsextensiveulcerationanddiffusethickeningwithaninflammatoryinfiltrate.IncontrasttoCrohn`scolitis,theulcerationlacksdepth.

溃疡性结肠炎的诊断与治疗Chroniculcerativecolitis

Figure4-5.Chroniculcerativecolitis.Inlong-standingulcerativecolitis,themucosahasanatrophicandscarredappearancewithabluntedvascularpattern.Pseudopolypsareoftenpresent.

溃疡性结肠炎的诊断与治疗Severeulcerativecolitiswithpseudopolyps

Figure4-4.Severeulcerativecolitiswithpseudopolyps.Inadditiontoseveremucosalulcerationandinflammation,chroniculcerativecolitisisoftenassoci