Bulfoni A
S.O.C. Medicina Interna 2, Azienda Ospedaliera Santa Maria della Misericordia di Udine, Italia.
Clin Ter. 2006 Sep-Oct;157(5):431-4.
A case of primary small bowel adenocarcinoma is reported because of the rarity of this malignancy. Interestingly, the location of the tumour was in jejunum, instead of the most common site in duodenum. The clinical presentation was anemia, with positive fecal blood test, under antiaggregant platelet treatment for coronary heart disease, initially related to endoscopic evidence of erosive gastroduodenitis. The exacerbation of gastrointestinal bleeding during proton pump inhibitors therapy and the recurrence of abdominal pain caused careful investigation. The source of the obscure gastrointestinal bleeding had been achieved by wireless capsule endoscopy, because of not diagnostic findings of conventional upper endoscopy control, colonscopy, double contrast enteroclysis and selective arteriography. The primary definitive therapy was a radical resection of the jejunal neoplastic loop, important prognostic factor.
报道了一例原发性小肠腺癌病例,因其较为罕见。有趣的是,肿瘤位于空肠,而非最常见的十二指肠部位。临床表现为贫血,粪便潜血试验呈阳性,患者正在接受冠心病抗血小板治疗,最初与内镜检查发现的糜烂性胃十二指肠炎症有关。质子泵抑制剂治疗期间胃肠道出血加剧以及腹痛复发促使进行了仔细检查。由于传统上消化道内镜检查、结肠镜检查、双重对比小肠造影和选择性动脉造影均未发现诊断结果,通过无线胶囊内镜检查找到了隐匿性胃肠道出血的源头。主要的确定性治疗方法是对空肠肿瘤肠袢进行根治性切除,这是一个重要的预后因素。