成人型环形胰腺临床特征及误诊漏诊分析  

Clinical features,misdiagnosis and missed diagnosis of adult annular pancreas

作　　者：冯云 徐小玲[2] 李晶[1] 许君望[1] 和水祥[1] 李红霞[1] 任牡丹[1] FENG Yun;XU Xiao-ling;LI Jing;XU Jun-wang;HE Shui-xiang;LI Hong-xia;REN Mu-dan(Department of Gastroenterology,the First Affiliated Hospital of Xi’an Jiaotong University,Xi'an 710061,China;不详)

机构地区：[1]西安交通大学第一附属医院消化内科,陕西西安710061 [2]西安交通大学第一附属医院医学影像科,陕西西安710061

出　　处：《中国实用内科杂志》2020年第10期829-831,共3页Chinese Journal of Practical Internal Medicine

基　　金：陕西省重点研发计划社会发展领域一般项目(2019SF-023)。

摘　　要：目的探讨成人型环形胰腺的临床特征及误诊、漏诊情况。方法纳入西安交通大学第一附属医院2014年8月至2019年12月收治的7例成人型环形胰腺患者,回顾性分析分析其临床特征及误诊、漏诊原因。结果成人型环形胰腺以上腹痛(85.7%)、恶心呕吐(71.4%)等十二指肠梗阻表现为主,初步诊断5例(71.4%)均误诊、漏诊,但其中4例(57.1%)经X线钡餐造影、腹部CT、磁共振胆胰管成像等检查并由经验丰富的影像科教授阅片后均明确诊断,1例(14.3%)经外科手术诊断。结论影像学检查对成人型环形胰腺具有重要诊断价值,其误诊、漏诊与影像科医师诊断经验不足密切相关。Objective To investigate the clinical features,diagnosis errors and missed diagnosis of adult annular pancreas.Methods seven adult patients with annular pancreas admitted to the First Affiliated Hospital of Xi’an Jiaotong University from August 2014 to December 2019 were included.The clinical characteristics,causes of diagnosis errors and missed diagnosis were analyzed retrospectively.Results The adult annular pancreas is characterized by duodenal obstruction,including upper abdominal pain(85.7%),nausea and vomiting(71.4%).The rate of initial diagnosis errors and missed diagnosis was as high as 71.4%.However,Four of them(57.1%)were clearly diagnosed by experienced radiological professors after imaging examinations such as upper gastrointestinal angiography,abdominal CT and MRCP.One case(14.3%)was finally diagnosed after surgery.Conclusion Imaging examination has important diagnostic value for the diagnosis of adult annular pancreas.The diagnosis errors and missed diagnosis are closely related to the inexperience of imaging physicians.

关 键 词：环形胰腺 十二指肠梗阻 误诊 漏诊 

分 类 号：R576[医药卫生—消化系统] R657.5[医药卫生—内科学]