溃疡性结肠炎的诊断与治疗文档.pptVIP

溃疡性结肠炎的诊断与治疗;内镜检查及X线检查;Endoscopicfeaturesofactiveulcerativecolitis

Figure4-1.Endoscopicfeaturesofactiveulcerativecolitis.Findingsincludediffuselyerythematous,edematous,andgranularmucosawithareasofsubmucosalhemorrhageand,whensevere,frankmucopurulentexudate.Inflammationinvariablybeginsintherectumandextendsproximallyforvaryingextents.Thechronicityoftheprocessissuggestedbythelossofcolonichaustrations;otherwise,theendoscopicpictureisnonspecificandcouldbeconsistentwithacuteinfectiouscolitis,chroniculcerativeorCrohn`scolitis,oranynumberofotherspecificcausesofcolitis.A,Milddistalulcerativecolitiswithdiffuseerythemaandfriabilitywelldemarcatedfromthenormalmucosamoreproximallyisdepicted.B,Thisexampleshowsmoderatelysevereulcerativecolitiswithirregular,inflamed,ulceratedmucosaandapatchyexudate.;Ulcerativecolitisinremission

Figure4-2.Ulcerativecolitisinremission.Thenormalvascularpatternisabsentandawhitescarindicatesthesiteofapreviousulcer.

;Severeulcerativecolitis

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

;Chroniculcerativecolitis

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

;Severeulcerativecolitiswithpseudopolyps

Figure4-4.Severeulcerativecolitiswithpseudopolyps.Inadditiontoseveremucosalulcerationandinflammation,chroniculcerativecolitisisoftenassociatedwiththeformationofpseudopolyps,whichrepresentislandsofregeneratingmucosaandexuberantinflammationamidstdiffusemucosaldestruction.Pseudopolypshavenomalignantpotential.

;远段结肠者可SASP栓剂0.

Chroniculcerativecolitis.

内镜检查表现：中毒性巨结肠是内镜绝对