十二指肠Brunner腺错构瘤(布氏腺瘤)致反复消化道出血1例并文献复习  

Recurrent gastrointestinal bleeding caused by Brunner′s adenohamartoma of duodenum:a case report and literature review

作　　者：李立亚 张丹 张纪娟 李长政 马晓冰 李萌 田甜 Li Liya;Zhang Dan;Zhang Jijuan;Li Changzheng;Ma Xiaobing;Li Meng;Tian Tian(Department of Gastroenterology,PLA Rocket Forces Characteristic Medical Center,Beijing 100088,China)

机构地区：[1]火箭军特色医学中心消化内科,北京100088

出　　处：《中华胃肠内镜电子杂志》2024年第3期182-185,共4页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

摘　　要：目的十二指肠Brunner腺错构瘤(Brunner′s gland hamartoma,BGH)是较为罕见的疾病,术前误诊率高。本文报告1例BGH伴反复消化道出血的诊治过程,并结合既往文献对本病特点进行总结,以期为临床工作提供借鉴。方法回顾性分析火箭军特色医学中心消化内科收治的1例BGH患者的临床资料和近10年文献报道个案共81例,并进行总结。结果本例患者因反复黑便发现十二指肠肿物,于我中心行内镜切除十二指肠4.5 cm×3 cm×1.8 cm肿物,病理诊断为错构瘤性息肉;文献报道病例主要表现为腹痛、黑便、恶心呕吐、贫血,89.19%肿物大小超过2 cm,选择外科手术、内镜切除和保守治疗分别占53.09%、41.98%、3.70%。结论BGH容易误诊,在十二指肠黏膜下肿物或消化道出血鉴别诊断中应加以考虑。Objective Brunner′s gland hamartoma of duodenum is a rare disease,with a high misdiagnosis rate before operation.This paper reports the diagnosis and treatment of a case of BGH with recurrent gastrointestinal bleeding,and summarizes the characteristics of this disease in combination with previous literature in order to provide reference for clinical work.Methods The clinical data of a patient with BGH admitted to the Department of Gastroenterology,PLA Rocket Forces Characteristic Medical Center were analyzed and 81 cases reported in recent 10 years were summarized.Results The patient in this center underwent endoscopic resection of a 4.5 cm×3 cm×1.8 cm duodenal tumor due to repeated black stool,and the pathological diagnosis was hamartomatous polyp.The cases reported in the literature mainly showed abdominal pain,melena,nausea and vomiting,and anemia.89.19%of the tumors were over 2 cm in size,and the percentage of chose of surgery,endoscopic resection and conservative treatment was 53.09%,41.98%and 3.70%respectively.Conclusion BGH is easy to be misdiagnosed and should be considered in the differential diagnosis of duodenal submucosal tumor or gastrointestinal bleeding.

关 键 词：十二指肠黏膜下肿物 错构瘤 消化道出血 

分 类 号：R735.3[医药卫生—肿瘤]