十二指肠粪类圆线虫病的临床、病理及内镜特征  

The clinical,histopathologic and endoscopic features of duodenal Strongyloidiasis

作　　者：郭晓红[1] 杨根源[2] 院秀娟[1] 叶峙良 

机构地区：[1]珠海市人民医院病理科,广东珠海519000 [2]珠海市人民医院内镜中心,广东珠海519000

出　　处：《胃肠病学和肝病学杂志》2016年第11期1299-1301,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：珠海市科技计划医疗卫生项目(2015A0024)

摘　　要：目的探讨十二指肠粪类圆线虫病的临床、病理组织学及内镜特点。方法回顾性分析珠海市人民医院诊治的1例十二指肠粪类圆线虫病的临床资料、实验室检查、内镜检查、病理组织学检查及治疗、随访情况并复习相关文献。结果患者男,40岁,右上腹阵发性疼痛、腹胀1年余,伴恶心、乏力及体质量减轻。慢性乙型病毒性肝炎病史30余年。血常规示:嗜酸性粒细胞计数及百分比升高。上消化道内镜检查示:十二指肠黏膜弥漫性充血水肿,皱襞肿胀,可见白色绒毛。组织病理学检查示:十二指肠黏膜慢性炎,伴嗜酸性粒细胞浸润,隐窝内及上皮内可见粪类圆线虫虫体及虫卵。最终诊断为十二指肠粪类圆线虫病。经阿苯达唑治疗后症状消失,随访10个月,无明显不适。结论粪类圆线虫病的早期正确诊断对治疗有重要指导意义。除粪便检查外,上消化道内镜检查并活检行组织学检查是一种准确的诊断方法。Objective To investigate the clinical, histopathologic and endoscopic features of duodenal Strongyloidiasis. Methods One case of duodenal Strongyloidiasis was analyzed retrospectively for clinical material, laboratory data, histopathological and endoscopic examination, treatment and follow up information, while review of the related litera- ture. Results A 40-year-old man with a medical history of Chronic Hepatitis B for more than 30 years complained of paroxysmal pain in right upper abdominal and abdominal distension for one year, accompanied with nausea,hypodynamia and weight loss. Routine blood test demonstrated elevated eosinophil count and eosinophil percentage. The upper gastro- intestinal endoscopy exhibited diffuse hyperemia and edema and swelling folds in the duodenal mucosa, also the duode- nal white villi. Histopathological examination revealed chronic inflammation in duodenal mucosa with many eosinophil infiltration while Strongyloides stercoralis appeared in the duodenal crypts and intraepithelial as eggs, rhabditoid and fi- lariform larvae, and adult females. Duodenal Strongyloidiasis was diagnosed. The patient was treated with albendazole with symptoms progressively improved, and at 10 months＇ follow-up, the patient was asymptomatic. Conclusion Early correct diagnosis of Strongyloioliasis has important guiding significance for treatment. In addition to the stool test, upper gastrointestinal endoscopy and biopsy for histopathology examination is an accurate and important diagnostic method.

关 键 词：粪类圆线虫病 内镜检查 组织病理学 十二指肠 慢性肝炎 结核 

分 类 号：R574.51[医药卫生—消化系统]