Free perforation of the small intestine in collagenous sprue  

作　　者：Hugh J Freeman Douglas L Webber 

机构地区：[1]Departments of Medicine(Gastroenterology),University of British Columbia,Vancouver,BC V6T 1W5,Canada [2]Departments of Pathology,University of British Columbia,Vancouver,BC V6T 1W5,Canada

出　　处：《World Journal of Gastroenterology》2009年第35期4446-4448,共3页世界胃肠病学杂志（英文版）

摘　　要：A 67-year-old man with celiac disease developed recurrent diarrhea,profound weakness and weight loss, with evidence of marked protein depletion.His clinical course was refractory to a strict gluten-free diet and steroid therapy.Postmortem studies led to definition of unrecognized collagenous sprue that caused ulceration and small intestinal perforation.Although PCR showed identical monoclonal T-cell populations in antemortem duodenal biopsies and postmortem jejunum,careful pathological evaluation demonstrated no frank lymphoma.Rarely,overt or even cryptic T-cell lymphoma may complicate collagenous sprue,however, small intestinal ulcers and perforation may also develop independently.The dramatic findings here may reflect an underlying or early molecular event in the eventual clinical appearance of overt T-cell lymphoma.A 67-year-old man with celiac disease developed recurrent diarrhea, profound weakness and weight loss, with evidence of marked protein depletion. His clinical course was refractory to a strict gluten-free diet and steroid therapy. Postmortem studies led to definition of unrecognized collagenous sprue that caused ulceration and small intestinal perforation. Although PCR showed identical monoclonal T-cell populations in antemortem duodenal biopsies and postmortem jejunum, careful pathological evaluation demonstrated no frank lymphoma. Rarely, overt or even cryptic T-cell lymphoma may complicate collagenous sprue, however, small intestinal ulcers and perforation may also develop independently. The dramatic findings here may reflect an underlying or early molecular event in the eventual clinical appearance of overt T-cell lymphoma.

关 键 词：Collagenous sprue Intestinal perforation Celiac disease Refractory sprue Intestinal neoplasms LYMPHOMA 

分 类 号：R656.7[医药卫生—外科学]