gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2025-24-1-38-45gnck-1989Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПатогистологические особенности Clostridium difficile-ассоциированного псевдомембранозного колита у пациентов, перенесших COVID-19Pathohistological features of Clostridium difficile-associated pseudomembranous colitis in post-COVID-19 patientshttps://orcid.org/0000-0001-6410-9003ТимербулатовВ. М.TimerbulatovV. M.

Тимербулатов Виль Мамилович — д.м.н., проф., член-корр. РАН, зав. кафедрой хирургии с курсом эндоскопии

ул. Ленина, д. 3, г. Уфа, 450008

Vil’ M. Timerbulatov 

Lenin st., 3, Ufa, 450008 

timervil@yandex.ruhttps://orcid.org/0009-0002-5746-1265МустафинТ. И.MustafinT. I.

Мустафин Тагир Исламнурович — д.м.н., проф., зав. кафедрой патологической анатомии

ул. Ленина, д. 3, г. Уфа, 450008

Tagir I. Mustafin 

Lenin st., 3, Ufa, 450008 

https://orcid.org/0000-0002-6664-1308ТимербулатовМ. В.TimerbulatovM. V.

Тимербулатов Махмуд Вилевич — д.м.н., проф., зав. кафедрой факультетской хирургии

ул. Ленина, д. 3, г. Уфа, 450008

Makhmud V. Timerbulatov 

Lenin st., 3, Ufa, 450008 

https://orcid.org/0000-0002-0882-4405ЩекинС. В.ShchekinS. V.

Щекин Сергей Витальевич — ассистент кафедры патологической анатомии 

ул. Ленина, д. 3, г. Уфа, 450008

Sergey V. Shchekin 

Lenin st., 3, Ufa, 450008 

https://orcid.org/0000-0002-4832-6363ТимербулатовШ. В.TimerbulatovSh. V.

Тимербулатов Шамиль Вилевич — д.м.н., доцент, профессор кафедры хирургии с курсом эндоскопии

ул. Ленина, д. 3, г. Уфа, 450008

Shamil’ V. Timerbulatov 

Lenin st., 3, Ufa, 450008 

https://orcid.org/0000-0003-2874-7213ГафароваА. Р.GafarovaA. R.

Гафарова Айгуль Радиковна — ассистент кафедры хирургии с курсом эндоскопии  

ул. Ленина, д. 3, г. Уфа, 450008

Aigul R. Gafarova 

Lenin st., 3, Ufa, 450008 

argafarova@yandex.ruhttps://orcid.org/0000-0003-1996-4830ГараевР. Р.GaraevR. R.

Гараев Руслан Ралифович — ассистент кафедрыхирургии с курсом эндоскопии 

ул. Ленина, д. 3, г. Уфа, 450008

Ruslan R. Garaev 

Lenin st., 3, Ufa, 450008 

ФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава РоссииРоссияBashkir State Medical UniversityRussian Federation2025210320252413845Copyright © Тимербулатов В.М., Мустафин Т.И., Тимербулатов М.В., Щекин С.В., Тимербулатов Ш.В., Гафарова А.Р., Гараев Р.Р., 20252025Тимербулатов В.М., Мустафин Т.И., Тимербулатов М.В., Щекин С.В., Тимербулатов Ш.В., Гафарова А.Р., Гараев Р.Р.Timerbulatov V.M., Mustafin T.I., Timerbulatov M.V., Shchekin S.V., Timerbulatov S.V., Gafarova A.R., Garaev R.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1989

ЦЕЛЬ: изучить особенности патоморфологических изменений стенки кишечника у пациентов, перенесших новую коронавирусную инфекцию SARS-CoV-2.ПАЦИЕНТЫ И МЕТОДЫ: в исследование включено 8 пациентов, оперированных по поводу осложнений псевдомембранозного колита, ранее перенесших COVID-19. Шести пациентам была выполнена колэктомия, а двум — субтотальная резекция ободочной кишки с концевой илеостомией. Гистологическое исследование удаленных препаратов проводилось по стандартной методике.РЕЗУЛЬТАТЫ: во всех препаратах, помимо изменений, характерных для псевдомембранозного колита, было выявлено поражение сосудов стенки в виде васкулита мелких артерий и сосудов микроциркуляторного русла, флебита и тромбоза венозных сосудов, характерных для COVID-19. Указанные патологические изменения сосудов могут являться свидетельством развития интрамуральных перфузионных расстройств кровообращения, приводящим в последующем к ишемическим изменениям.ЗАКЛЮЧЕНИЕ: при лечении пациентов псевдомембранозным колитом и постковидным синдромом, необходимо принимать во внимание взаимно отягощающее действие обоих заболеваний, что должно учитываться при оценке рисков, определении показаний к операции и консервативных мероприятиях.

AIM: to assess features of pathomorphological changes in the intestinal wall in patients who had new coronavirus infection SARS-CoV-2.PATIENTS AND METHODS: the study included 8 patients who underwent surgery for complications of pseudomembranous colitis and had previously COVID-19. Six patients underwent colectomy, and two underwent subtotal colectomy with end ileostomy. Histology of the removed specimens was standard.RESULTS: in all specimens, in addition to the changes peculiar for pseudomembranous colitis, vascular lesions of the bowel wall were detected as vasculitis of small arteries and vessels of the microcirculatory network, phlebitis and thrombosis of venous vessels like in COVID-19. These pathological changes in blood vessels may reveal the intramural perfusion disorders of blood circulation, leading subsequently to ischemic changes.CONCLUSION: when treating patients with pseudomembranous colitis and postcovid syndrome, it is necessary to take into account the mutually aggravating effect of both diseases, when assessing risks, determining indications for surgery and conservative measures.

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The authors declare that there are no conflicts of interest present.