CT Findings of Fulminant Amebic Colitis: A Case Report

猛暴性阿米巴大腸炎之電腦斷層表徵：病例報告

英恭史(Kung-Shih Ying) ； 陳禮平(Lai-Ping Chan) ； 吳新華(Shin-Hwa Wu) ； 吳明哲(Min-Jer Wu) ； 張泰裕(Tai-Yu Chang) ； 李宗憲(Chung-Hsien Lee)

《中華放射線醫學雜誌》 33卷3期 (2008/09) Pp. 205-210

摘要

猛暴性阿米巴大腸炎，是阿米巴痢疾感染的一種不尋常表現。其電腦斷層表徵很少在文獻上發表過。了解其在病理上的形態學變化，可以使我們更容易了解並偵測到其在電腦斷層上之特徵。它的典型病理特徵，就在肉眼即可看出之外觀；在大腸上可以看到多處組織壞死及穿孔。猛暴性阿米巴大腸炎是先由淺層之腸壁黏膜潰瘍發展至全層腸壁之壞死，並合併有典型的燒杯狀潰瘍。由黏膜潰瘍至黏膜下潰瘍所發展出的擴張性黏膜下潰瘍合併腸壁內之剝離延伸，是猛暴性阿米巴大腸炎之典型電腦斷層特徵。另泛大腸炎合併有標靶樣之腸壁增厚及多處非連續性之腸壞死也是其電腦斷層之重要發現。

並列摘要

Fulminant amebic colitis is an uncommon manifestation of amebiasis. The computed tomography (CT) appearance of fulminant amebic colitis (FAC) is rarely reported. Understanding the pathologic change of FAC may help recognize the characteristic CT findings of FAC. The classic pathologic feature of FAC is the macroscopic appearance. FAC usually shows multiple sites of necrosis and perforation of the colon, ranging from superficial ulcer, flask-shaped ulcer to transmural necrosis. Extended submucosal ulcer with intramural dissection is the characteristic CT finding of FAC. Other important CT findings include pancolitis with multiple foci of target sign and discontinuous bowel necrosis.