上消化道异位胰腺35例临床分析  

Clinical analysis of 35 cases of upper gastrointestinal heterotopic pancreas

作　　者：沈杰[1] 李智[1] 肖玉良[1] 邹玉[1] 陈韩[1] 何夕昆[1] 

机构地区：[1]云南省第二人民医院消化内科,昆明650021

出　　处：《重庆医学》2013年第27期3244-3245,3248,共3页Chongqing medicine

摘　　要：目的探讨上消化道异位胰腺的临床、胃镜、内镜超声（EUS）表现及治疗价值。方法分析该院经病理证实的35例上消化道异位胰腺患者的临床资料，总结其临床症状，胃镜、内镜超声表现及内镜下治疗效果。结果35例患者中临床上有症状者30例，上腹痛18例，腹胀5例，嗳气4例，黑便3例；病灶位于胃窦23例，胃体3例，胃底3例，胃角2例，胃窦体交界2例，十二指肠球部2例。内镜下表现为隆起性病变，直径0．5～2．0cm，20例中央有脐样凹陷，项端可见导管开口，内镜超声下，病变位于黏膜下层28例，累及黏膜层2例，黏膜肌层4例，固有肌层1例，表现为中等回声4例，低回声24例，混合回声7例，其中10例可见管状结构样回声。20例行内镜下黏膜切除术（EM R），15例行内镜下套扎联合高频电切除术，术中出血3例，未见穿孔等其他并发症。结论上消化道异位胰腺临床表现无特异性，胃镜联合内镜超声对其诊断，并指导内镜下治疗有重要价值。内镜下EM R术及套扎联合高频电切除术是治疗上消化道异位胰腺的一种安全、有效的治疗手段。Objective To explore the cinical ,endoscopic and endoscopic ultrasonography （EUS） manifestations of upper gastro-intestinal heterotopic pancreas（HP） and the treatment value .Methods The clinical data in 35 cases of upper gastrointestinal HP confirmed by pathology in our hospital were retrospectively analyzed for summarizing its clinical symptoms ,endoscopic and EUS manifestations and the treatment effect under endoscopy .Results Among all the 35 cases ,the cinlincal symptoms were in 30 cases , upper abdominal pain in 18 cases ,abdominal distension in 5 cases ,belching in 4 cases ,melena in 3 cases ,the lesion was located in gastric antrum in 23 cases ,in gastric body in 3 cases ,in gastric fundus in 3 cases ,in gastric angle in 2 cases ,in the junction of gastric antrum and corpus ventriculi in 2 cases ,in durodenal bulb in 2 cases ,most HP were represented by protuberant lesions under endos-copy ,the diameter of the lesions ranged 0 .5-2 .0 cm .20 cases were centrally umbilicated hollow with ducts opening on the top of the protuberant lesion .Under EUS ,the lesions involved submucosa in 28 cases ,mucosa in 2 cases ,muscularis mucosae in 4 cases , and muscularis propria in 1 case .4 cases appeared as the midium echo ,24 cases as hypoecho and 7 cases as mixed echo ,among them ,the tubular structure echo within the lesions were found in 10 cases .20 cases were treated by endoscopic mucosal resection （EMR） ,15 cases were performed the ligation combined with the high frequency electroresection .Intraoperative bleeding occurred in 3 cases and no other complicntions such as perforation occurred .Conclusion The clinical manifestations of upper gastrointestinal HP have no specificity .Gastroendoscopy combimed with EUS has the important value in the diagnosis and endoscopis therapy .En-doscopic EMR and ligation combined with the high frequency electroresection are the safe and effective means for treating upper gastrointestinal HP .

关 键 词：胰腺 内窥镜检查 超声检查 

分 类 号：R57[医药卫生—消化系统]