摘要
目的提高临床和内镜医师对食管近段异位胃黏膜的认识,减少误诊和误诊。方法结合我科近期遇到的1例少见的以呕血为首发表现的食管近段异位胃黏膜病例,进行文献复习,并从发病机制、临床特点、诊断治疗等方面和Barrett食管进行比较系统的比较。结果文献复习表明,虽然食管近段异位胃黏膜和Barrett食管可能有相似的临床表现,诊断也都依赖于胃镜和病理活检检查,但是二者有不同的组织细胞来源、发病机制和临床意义,在治疗和随访意见上也不尽相同。结论食管近段异位胃黏膜是先天性的黏膜病变,也是可能的食管腺癌癌前病变。虽然患者一般症状轻微,但是也可能以呕血、穿孔等较严重的临床症状为首发表现。广大临床和内镜医师有必要加强对此病的认识,进行正确的诊断和处理,避免和Barrett食管相混淆。
ObjectiveTo improve the understanding of proximal esophageal heterotopic gastric mucosa and reduce misdiagnosis and missed diagnosis.MethodsThe clinical data of one patient in our hospital with proximal esophageal heterotopic gastric mucosa was described and relevant literature was reviewed.ResultsAlthough patients with proximal esophageal heterotopic gastric mucosa or Barrett’s esophagus could have similar clinical presentations and both of their diagnoses depend on endoscopy and pathological diagnosis, they had different etiology, pathogenesis and many other clinical features. ConclusionProximal esophageal heterotopic gastric mucosa is congenital; however, Barrett’s esophagus is acquired disease due to reflux. Although symptoms are generally mild in patients with proximal esophageal heterotopic gastric mucosa, hematemesis or perforation could be initial presentation. Physicians and endoscopists should be aware of this disease and able to make differential diagnosis with Barrett’s esophagus.
出处
《中华临床医师杂志（电子版）》
CAS
2015年第15期158-160,共3页
Chinese Journal of Clinicians(Electronic Edition)
