异位胰腺38例诊治分析  

Diagnosis and treatment of 38 cases of heterotopic pancreas

作　　者：黄湘辉 武鸿彪 丁小云[1] 严志龙[1] 袁旦平[1] HUANG Xianghui;WU Hongbiao;DINGXiaoyun;YAN Zhilong;YUAN Danping(Department of Anorectal Surgery, Ningbo First Hospital, Ningbo 315010, Zhejiang, China)

机构地区：[1]宁波市第一医院肛肠外科,浙江宁波315010

出　　处：《上海医学》2019年第1期11-15,共5页Shanghai Medical Journal

摘　　要：目的探讨异位胰腺的临床表现、诊断和治疗方法。方法回顾性分析宁波市第一医院外科手术或内镜治疗后经病理检查证实的38例异位胰腺患者的临床表现、诊断方法和治疗等临床资料。结果 38例异位胰腺患者中,34例患者有腹痛、腹胀、反酸、黑便等消化系统症状,4例无特殊不适。36例异位胰腺分布于胃,其中胃窦24例,胃体11例,胃底1例;2例位于十二指肠球部。34例患者接受超声内镜检查,表现为均匀或不均匀低回声27例(79.4%),高回声5例(14.7%),不均质回声2例(5.9%);中位直径1.5 cm(0.7～4.0 cm);其中10例诊断为异位胰腺(准确率29.4%),11例误诊为间质瘤,2例误诊为脂肪瘤,2例误诊为胃息肉,1例误诊为神经内分泌瘤,1例误诊为胃囊肿,1例误诊为胃囊肿伴溃疡,其余6例性质不明。34例行内镜下治疗,4例行外科手术治疗,随访无患者复发或死亡。结论异位胰腺的临床表现缺乏特异性,超声内镜检查是异位胰腺的首选检查方法,治疗方法推荐以内镜下治疗为首选,外科切除次之。Objective To explore the clinical manifestation, diagnosis and treatment of heterotopic pancreas. Methods Clinical data including clinical manifestation, diagnosis and treatment of 38 patients with heterotopic pancreas confirmed by pathology after surgery or endoscopic treatment were analyzed retrospectively in our hospital. Results Clinical manifestations of digestive system such as abdominal pain, abdominal distension, sour regurgitation and melena presented in 34 cases, and 4 cases had no special discomfort. Heterotopic pancreas was found in the stomach of 36 cases, such as gastric antrum(24 cases), gastric body(11 cases), gastric fundus(one case), and was also seen in the duodenal bulb of two cases. Endoscopic ultrasonography was performed in 34 cases, characterized by uniform or nonuniform hypoechoic in 27 cases(79.4%), hyperechoic in five cases(14.7%), and heterogeneous echopattern in two cases(5.9%), with a median diameter of 1.5 cm(0.7-4.0 cm). Of them, 10 cases were diagnosed as heterotopic pancreas(diagnostic accuracy was 29.4%), 11 cases were misdiagnosed as gastrointestinal stromal tumor, two cases of gastrointestinal lipoma, two cases of gastric polyps, one case of neuroendocrine tumor, one case of gastric cyst, one case of gastric cyst and ulcer, and the remaining six cases were unknown in nature. Totally 34 cases were treated with endoscopy and four cases were treated by surgery. No patient died during follow up. Conclusion The clinical manifestations of heterotopic pancreas are not specific. Endoscopic ultrasonography is the first choice for the diagnosis of heterotopic pancreas. The most recommended treatment is endoscopic treatment, followed by surgical resection.

关 键 词：腔内超声内镜检查 异位胰腺 诊治 

分 类 号：R576[医药卫生—消化系统]