The clinical feature analysis of acute ischemic bowl disease / 中国基层医药

ABSTRACT

Objective To explore the clinical features of acute ischemic bowl disease in order to guide clinical treatment and avoid the severe complications.Methods 25 cases diagnosed as ischemic bowl disease were enrolled retrospectivly analysed the clinical features of symptoms,signs,laboratory test results,abbominal enhanced CT and CTA,enteroscopes of these patients.Results Among the 25 cases accorrding to first presentation of first contacts,the cardinal symptoms were spectively abdomial pain 20 (80％),abdomial distension 16 (64％),diarrhea 18 (72％),vomiting 13 (52％),hemafecia 6 (24％),bloody purulent stool 8 (32％),watery stool 7 (28％),fever 11 (44％) and physical signs were spectively local tenderness 12(48％),peritonitis sign 9(36％),active bowl sound 7 (28％),weak or disappeared bowl sound 5 (20％).22 of 25 cases were positive with ocult blood test of stool and 23 of 25 cases showed elevated D-dimer concentration(more than 500μg/L) within 24 hours after first contacts.All the 25 cases were dignosed with CTA and 1 case was performed with enteroscopy which showed that local mucosa of sigmoid colon was congestive,edema,submucosal extravasated blood and some part was bleeding.Conclusion The patient with high risk factors who suffered from the tetralogy of severe abdominal pain,intense evacuation symptoms,highly elevated D-dimer concentration and positive ocult blood test,is stongly suggested to be a ischemic bowl disease and should be performed the abdomial CTA or DSA examination in time to avoid missing the golden opportunity to cure.