Soon M S, Lin O S
Division of Gastroenterology, ChangHua Christian Medical Center, ChangHua, Taiwan.
Surg Endosc. 2000 Jan;14(1):86. doi: 10.1007/s004649901204. Epub 1999 Nov 25.
Duodenal inflammatory fibroid polyps (IFP) are extemely rare lesions indistinguishable from submucosal tumors by endoscopic inspection alone. Like gastric inflammatory fibroid polyps, they can be managed by endoscopic polypectomy or mucosectomy. However, preoperative diagnosis of this benign lesion is difficult. Here we present a case of duodenal IFP causing gastrointestinal bleeding that was evaluated by endoscopic ultrasound before surgical removal. On endosonography, the duodenal IFP appeared as a coarsely heterogeneous isoechoic and hypoechoic mass circumscribed by a distinct margin and arising from the third layer of the duodenal wall. The endosonographic appearance of this lesion was in marked contrast to that previously reported for gastric IFPs, which have tended to appear as hypoechoic homogeneous lesions with indistinct margins. Endosonographic evaluation of suspected IFPs before endoscopic or surgical treatment is useful. However, the endosonographic appearances of duodenal and gastric IFPs may be significantly different, possibly because of differences in the makeup of the duodenal and gastric walls.
十二指肠炎性纤维性息肉（IFP）极为罕见，仅通过内镜检查无法与黏膜下肿瘤区分开来。与胃炎性纤维性息肉一样，它们可通过内镜下息肉切除术或黏膜切除术进行治疗。然而，这种良性病变的术前诊断较为困难。在此，我们报告一例导致胃肠道出血的十二指肠IFP病例，在手术切除前通过内镜超声进行了评估。在超声内镜检查中，十二指肠IFP表现为边界清晰、起源于十二指肠壁第三层的粗糙不均质等回声和低回声肿块。该病变的超声内镜表现与先前报道的胃IFP明显不同，胃IFP往往表现为边界不清的低回声均匀性病变。在内镜或手术治疗前对疑似IFP进行超声内镜评估是有用的。然而，十二指肠和胃IFP的超声内镜表现可能存在显著差异，这可能是由于十二指肠壁和胃壁组成的差异所致。
