Floer Martin, Hlouschek Verena, Krieglstein Christian F, Bettendorf Olaf, Domschke Wolfram, Pohle Thorsten
Department of Medicine B, University of Münster, Germany.
Scand J Gastroenterol. 2005 Apr;40(4):482-5. doi: 10.1080/00365520510012082.
Tumors of the small intestine are rare as compared to malignant tumors of the pancreas. Here we report on the case of a 61-year-old man suffering from chronic pancreatitis presenting with a lesion projecting into the pancreatic head shown by both computed tomography and transabdominal ultrasound. Pancreatic cancer was suspected, but endoscopic ultrasound revealed this lesion to be situated in the submucosal layer of the duodenal wall. Surgery was performed since biopsy of this lesion was not diagnostic and a malignant leiomyosarcoma could therefore not be excluded. Limited surgery comprised resection of the duodenal lesion, whereas based on computed tomography alone, exploration of the pancreas would have been performed. Thus, in the present case endoscopic ultrasound leads to a more appropriate, less invasive therapeutic measure.
与胰腺恶性肿瘤相比，小肠肿瘤较为罕见。在此，我们报告一例61岁患有慢性胰腺炎的男性病例，计算机断层扫描和经腹超声均显示有一病变突入胰头。怀疑为胰腺癌，但内镜超声显示该病变位于十二指肠壁的黏膜下层。由于对该病变进行活检未能确诊，因此不能排除恶性平滑肌肉瘤的可能，故而实施了手术。有限手术包括切除十二指肠病变，而若仅依据计算机断层扫描，本应探查胰腺。因此，在本病例中，内镜超声促成了更恰当、侵入性更小的治疗措施。
