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本文报告4例误诊为慢性结肠炎的鞭虫病,并简要讨论误诊原因,以利吸取教训。例1,男,26岁,农民。因双侧下腹痛、腹泻2年就诊,其间查大便常规多次,有少许脓球和红细脑,三次大便培养细菌阴性,纤维结肠镜检查显示升结肠粘膜有数个针尖大小出血点,其周围粘膜轻度水肿,诊断为“慢性结肠炎”,经多种抗生素治疗效果不佳。查体:右中腹部轻度压痛。再行纤维结肠镜检查发现回盲瓣附近有一条鞭虫,给予肠虫清治疗后症状消失,随访2个月症状无发作,大便常规正常。
This article reports 4 cases of misdiagnosed chronic colitis whipwormosis, and briefly discusses the reasons for misdiagnosis in order to facilitate the lessons learned. Example 1, male, 26 years old, farmer. Due to bilateral lower abdominal pain, diarrhea 2 years treatment, check the stool routine times, a little pus ball and red brain, three stool bacterial culture negative, colonoscopy showed ascending colonic mucosa several needle-sized bleeding point, around it Mild mucosal edema, diagnosed as “chronic colitis”, after a variety of antibiotic treatment ineffective. Physical examination: mild tenderness in the right middle abdomen. Recurrence of colonoscopy found ileocecal valve near a whipworm, to give intestinal worms clear symptoms disappeared, followed up for 2 months without symptoms, stool routine normal.