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单气囊小肠镜在成功治疗 3 例独立起源胃肠道恶性肿瘤中的术前诊断价值:病例报告。

Preoperative diagnostic value of single-balloon enteroscopy for successful surgical treatment of three independent-origin gastrointestinal malignant tumors: report of a case.

机构信息

Department of Surgery, Nippon Steel Yawata Memorial Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Kitakyushu, 805-8508, Japan.

出版信息

Surg Today. 2011 Jul;41(7):1007-10. doi: 10.1007/s00595-010-4399-5. Epub 2011 Jul 12.

Abstract

A 67-year-old woman with bloody stools underwent esophagogastroduodenoscopy and colonoscopy, which revealed the presence of a submucosal tumor in the stomach and an adenocarcinoma in the ascending colon. Preoperative screening disclosed an additional 10-cm tumor in the abdomen between the gastric and colonic lesions. Single-balloon enteroscopy was therefore performed. A nonstenotic, circumferential, bleeding ulcerative lesion was found in the jejunum, and the biopsy revealed malignant lymphoma (ML). A partial resection of the small intestine, ascending colectomy, and wedge resection of the stomach were performed, then systemic chemotherapy for ML was started 2 weeks after surgery. Triple gastrointestinal malignant tumors with different histologies are extremely rare, and have not been previously reported. Single-balloon enteroscopy in this case led to a definite diagnosis by biopsy, thus allowing the patient to receive chemotherapy as soon as possible after surgery.

摘要

一位 67 岁女性因便血接受了食管胃十二指肠镜和结肠镜检查,结果显示胃内有黏膜下肿瘤,升结肠有腺癌。术前筛查发现胃和结肠病变之间的腹部还有一个 10 厘米大的肿瘤。因此进行了单气囊小肠镜检查。在空肠发现一个非狭窄、环状、出血性溃疡性病变,活检显示恶性淋巴瘤(ML)。行小肠部分切除、升结肠切除术和胃楔形切除术,术后 2 周开始进行 ML 的全身化疗。三种不同组织学类型的胃肠道恶性肿瘤极为罕见,既往未有报道。本例中单气囊小肠镜检查通过活检明确诊断,使患者在术后尽快接受化疗。

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