Madura J A, Goulet R J, Wahle D T
Department of Surgery, Indiana University School of Medicine, Indianapolis.
Am Surg. 1991 Sep;57(9):607-14.
Duodenal webs and diaphragms in the adult are congenital in origin and are rare. They are explained embryologically by the process of duodenal epithelial plugging and subsequent revacuolization. The symptoms may be insidious and appear late in life and consist of partial gastric outlet complaints. Two thirds of the patients will have other upper GI problems, some of which may be related to the antral distension and stasis produced by the web. Peptic ulcer disease is common but may resolve when the web is excised. Diagnosis can be made by contrast duodenography but is more definitive with endoscopy. Therapy should be directed at web excision if possible. Associated ulcer disease should be selectively approached. The results of therapy in the reported cases have been successful when the web is surgically excised without additional ulcer procedures.
成人十二指肠蹼和隔膜起源于先天性，较为罕见。从胚胎学角度来看，它们是由十二指肠上皮堵塞及随后的再空泡化过程所导致的。症状可能较为隐匿，在生命后期才出现，主要表现为部分胃出口梗阻的症状。三分之二的患者会有其他上消化道问题，其中一些可能与蹼导致的胃窦扩张和淤滞有关。消化性溃疡疾病很常见，但在切除蹼后可能会缓解。十二指肠造影可用于诊断，但内镜检查更具确定性。治疗应尽可能针对蹼切除。对于相关的溃疡疾病应采取选择性治疗方法。在已报道的病例中，如果在不进行额外溃疡手术的情况下手术切除蹼，治疗效果是成功的。
