嗜酸细胞胃肠炎病例课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Case Review,Case Review,1,现病史,患者,男,48岁,杭州人,经商,患者半月余前无明显诱因下出现上腹痛,不剧可忍,持续2,小时后缓解,无肩背部放射痛,无发热畏寒,无恶心呕吐,无肛门停止排气排便,无胸闷心悸,无呕血黑便,此后上腹,部隐痛每天发作23次,与进食、排便无明显相关,半月来,患者自觉症状加重,上腹部持续隐痛不适,阵发性加重,有,时较难忍,发作频率增加,遂来我院就诊。,自病以来,神清,精神可,胃纳可,睡眠一般,大小便无殊,体重无明显减轻。,现病史,2,嗜酸细胞胃肠炎病例课件,3,体格检査,神清,精神偏软,生命体征平稳,浅表淋巴结未,及肿大,两肺呼吸音清,未闻及啰音,心律齐,未闻及杂音,腹软,上腹部及脐上轻压痛,无反,跳痛,肠鸣音6次/分,双下肢无水肿,体格检査,4,辅助检査,腹部CT:肝内小钙化灶,右肾小结石,右肾盂旁囊性灶,肾盂旁囊,肿可能。,胃镜:胃腔内大量食物残留,影响观察;病理:慢性炎,灶性活动性,灶性肠化,幽门螺杆菌:阴性,辅助检査,5,嗜酸细胞胃肠炎病例课件,6,诊治经过,死合力,电哇抗,师,率,3公式法,体积,白AF化学发,4区抗原CEA化学发光,血I化学,性,诊治经过,7,诊治经过,予屈他维林、泮托拉唑静滴,患者症状无缓解,BUS:肝内钙化灶,右肾小结石,H14m0.0,玩,150.4,E6.6,血不积,诊治经过,8,嗜酸细胞胃肠炎病例课件,9,鉴别诊断,Primary,Primary eosinophilic gastroenteritis,mucosa,Prmary eosinophilic colitis,Secondary: eosinophilic Hypereosinophilic syndrome,Secondar: non-,Inflammatory bowel disease,Esinophilic related,Coeliac disease,and fungi, Clostridum domicile, ShigeTa,Lymphangiectasia,Lymphoma/carcinoma,Connective tissue disease (scleroderma,Stauss,Graft versis host disease,Systemic mastocytosis,Drugs/iatrogenic,Yan and shaffer. Gut 2009,鉴别诊断,10,嗜酸细胞胃肠炎病例课件,11,嗜酸细胞胃肠炎病例课件,12,嗜酸细胞胃肠炎病例课件,13,嗜酸细胞胃肠炎病例课件,14,嗜酸细胞胃肠炎病例课件,15,嗜酸细胞胃肠炎病例课件,16,嗜酸细胞胃肠炎病例课件,17,嗜酸细胞胃肠炎病例课件,18,嗜酸细胞胃肠炎病例课件,19,嗜酸细胞胃肠炎病例课件,20,嗜酸细胞胃肠炎病例课件,21,嗜酸细胞胃肠炎病例课件,22,嗜酸细胞胃肠炎病例课件,23,嗜酸细胞胃肠炎病例课件,24,嗜酸细胞胃肠炎病例课件,25,嗜酸细胞胃肠炎病例课件,26,嗜酸细胞胃肠炎病例课件,27,嗜酸细胞胃肠炎病例课件,28,嗜酸细胞胃肠炎病例课件,29,嗜酸细胞胃肠炎病例课件,30,嗜酸细胞胃肠炎病例课件,31,嗜酸细胞胃肠炎病例课件,32,嗜酸细胞胃肠炎病例课件,33,嗜酸细胞胃肠炎病例课件,34,嗜酸细胞胃肠炎病例课件,35,嗜酸细胞胃肠炎病例课件,36,嗜酸细胞胃肠炎病例课件,37,嗜酸细胞胃肠炎病例课件,38,嗜酸细胞胃肠炎病例课件,39,嗜酸细胞胃肠炎病例课件,40,