摘要
目的探讨胃十二指肠克罗恩病的临床特点和超声内镜表现。方法收集1999年1月～2007年6月复旦大学附属中山医院确诊为胃十二指肠克罗恩病的相关资料并进行随访。结果 5例胃十二指肠克罗恩病患者中,1例胃克罗恩病,临床表现为中上腹胀痛和恶心,内镜表现为胃黏膜皱襞增粗僵硬伴纵行溃疡形成,超声内镜表现为胃壁黏膜及黏膜下层广泛增厚,呈均匀偏高回声。4例十二指肠球部克罗恩病,临床表现为反复上腹饱胀伴呕吐,内镜表现为十二指肠铺路石样改变、溃疡或狭窄,超声内镜表现为黏膜和黏膜下层广泛增厚。胃克罗恩病术前疑为恶性肿瘤,行全胃切除术。十二指肠球部克罗恩病经病理组织学、结肠镜检查等明确诊断,应用泼尼松等治疗缓解。结论胃镜检查病理阴性的胃十二指肠病灶应考虑克罗恩病可能,超声内镜有助于诊断的确立及与浸润性肿瘤的鉴别,结肠镜检查有助于发现回结肠病变并协助诊断克罗恩病。
Objective To investigate the clinical features and endosonographic manifestation of gastroduodenal Crohn’s disease. Methods Data from patients who were diagnosed as gastroduodenal Crohn’s disease in Zhongshan Hospital affiliated to Fudan University from Jan 1999 to Jun 2007 were collected and followed up. Results Among the 5 patients diagnosed as gastroduodenal Crohn’s disease,one patient was gastric Crohn’s disease presented with epigastric distending pain and nausea. Endoscopic findings revealed thickening and rigor of mucosal fold with longitudinal ulceration. Endosonography revealed extensive thickening of mucosal and submucosal layer with homogenous hyperecho. Four patients were duodenal Crohn’s diseases presented with epigastric float and vomit. Endoscopic findings revealed ulceration,stricture or cobblestone-like change of duodenal mucosa. Endosonography revealed extensive thickening of mucosa and submucosal layers. Gastric Crohn’s disease was suspicious of malignant tumor before operation and total gastric ectomy was performed. Duodenal Crohn’s disease was diagnosed based on histopathology and colonoscopy and it improved after prednisone therapy. Conclusion Crohn’s disease should be considered when gastroduodenal lesion is presented with negative pathological findings. Endosonographic examination contributes to clearfy the diagnosis and differentiate with infiltration tumor. Colonoscopy is beneficial to find the ileocolon lesions and help to diagnose Crohn’s disease.
出处
《胃肠病学和肝病学杂志》
CAS
2010年第11期1022-1024,共3页
Chinese Journal of Gastroenterology and Hepatology
关键词
胃十二指肠
克罗恩病
超声内镜
Gastroduodenal
Crohn’s disease
Endosonography
