UNASSIGNED: A 60-year-old female suffered from diarrhea, vomiting, and epigastric pain for 4 months. After demonstration of a dilated rectum with heterogeneous collection on ultrasonography, contrast-enhanced computed tomography (CECT) along with rectal contrast was done, which showed heterogeneously enhancing asymmetrical circumferential thickening of the proximal rectum, including rectosigmoid junction, collection in the rectum and two recto-jejunal fistulous tracts. Colonoscopy showed ulcero-proliferative growth in the rectum with two fistulous tracts communicating with the jejunum. Biopsy from the growth indicated a poorly differentiated adenocarcinoma. Conservative and palliative treatment was provided.
UNASSIGNED: Clinical features of colo-enteric fistulas can include abdominal pain, diarrhea, and weight loss. The patient may be asymptomatic in some cases. Options for diagnosis include barium studies, enteroscopy, colonoscopy, CECT, and computed tomography enterography (CTE). Malignant bowel fistula is associated with serious complications resulting in high morbidity and mortality rates. Surgical resection and fistula repair are the mainstay of curative treatment.
UNASSIGNED: Long-standing gastrointestinal symptoms like chronic diarrhea in the elderly should be investigated with imaging modalities like CECT. Early detection with imaging can reduce debilitating metabolic and nutritional deficiencies and improve patient\'s morbidity and mortality.
■一名60岁的女性腹泻,呕吐,上腹痛4个月。在超声检查显示直肠扩张并收集不均后,对比增强计算机断层扫描(CECT)以及直肠造影,显示近端直肠的不对称周向增厚不均匀增强,包括直肠乙状结肠交界处,收集在直肠和两个直肠空肠瘘管中。结肠镜检查显示直肠中的溃疡增生性生长,两个瘘管与空肠连通。生长活检显示低分化腺癌。提供保守和姑息治疗。
■结肠肠瘘的临床特征可能包括腹痛,腹泻,和减肥。在某些情况下,患者可能无症状。诊断的选择包括钡研究,小肠镜检查,结肠镜检查,CECT,和计算机断层成像(CTE)。恶性肠瘘与导致高发病率和死亡率的严重并发症相关。手术切除和瘘管修复是治愈性治疗的主要手段。
■老年人的长期胃肠道症状,如慢性腹泻,应使用CECT等影像学检查方法进行研究。早期影像学检查可以减少使人衰弱的代谢和营养缺乏,并改善患者的发病率和死亡率。