溃疡性结肠炎的诊疗和治疗课件

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Figure 4-4. Severe ulcerative colitis with pseudopolyps. In addition to severe mucosal ulceration and inflammation, chronic ulcerative colitis is often associated with the formation of pseudopolyps, which represent islands of regenerating mucosa and exuberant inflammation amidst diffuse mucosal destruction. Pseudopolyps have no malignant potential.
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
Endoscopic features文o档f a仅ct供iv参e 考ul，ce不ra能tiv作e为co科li学tis依据，请勿模仿；如有不当之处，请联系网站或本人删除。
Figure 4-1. Endoscopic features of active ulcerative colitis. Findings include diffusely erythematous, edematous, and granular mucosa with areas of submucosal hemorrhage and, when severe, frank mucopurulent exudate. Inflammation invariably begins in the rectum and extends proximally for varying extents. The chronicity of the process is suggested by the loss of colonic haustrations; otherwise, the endoscopic picture is nonspecific and could be consistent with acute infectious colitis, chronic ulcerative or Crohn`s colitis, or any number of other specific causes of colitis. A, Mild distal ulcerative colitis with diffuse erythema and friability well demarcated from the normal mucosa more proximally is depicted. B, This example shows moderately severe ulcerative colitis with irregular, inflamed, ulcerated mucosa and a patchy exudate.
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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。
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Severe ulcer文a档tiv仅e供c参ol考it，is不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。
Figure 4-6. Radiographic appearance of severe ulcerative colitis. This single-contrast barium enema demonstrates the typical ragged and ulcerative appearance of the mucosa in active ulcerative colitis. Characteristic collar-button or undermining ulcers are seen. In general, barium enema and colonoscopy should be avoided in fulminant ulcerative colitis because of the possibility of precipitating toxic megacolon.
Severe ul文ce档r仅a供ti参v考e，c不o能li作ti为s科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。
Figure 4-3. Severe ulcerative colitis. The mucosa shows extensive ulceration and diffuse thickening with an inflammatory infiltrate. In contrast to Crohn`s colitis, the ulceration lacks depth.
Chronic ulcerativ文e 档co仅lit供is参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。
Figure 4-5. Chronic ulcerative colitis. In long-standing ulcerative colitis, the mucosa has an atrophic and scarred appearance with a blunted vascular pattern. Pseudopolyps are often present.
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Figure 4-2. Ulcerative colitis in remission. The normal vascular pattern is absent and a white scar indicates the site of a previous ulcer.