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腹腔镜治疗空肠黏液腺癌合并乳糜泻。病例报告。

Laparoscopic treatment of mucinous adenocarcinoma of jejunum associated with celiac disease. Case report.

作者信息

Vecchio R, Marchese S, Gangemi P, Alongi G, Ferla F, Spataro C, Intagliata E

机构信息

"Policlinico Vittorio Emanuele" Hospital, Department of Surgery, Laparoscopic Surgery Unit, University of Catania, Catania, Italy.

出版信息

G Chir. 2012 Apr;33(4):126-8.

Abstract

Mucinous adenocarcinoma of the small bowel is very rare, and only few cases have been described in the literature. Association of this tumor with celiac disease has never been published. The authors report a unique case of jejunal mucinous adenocarcinoma in which a concomitant celiac disease has been histologically recognized. The difficult diagnosis, the role of laparoscopic surgery and the relationship between small bowel tumors and celiac disease are discussed. A 49-year-old man presented with recurrent melena, nausea, vomiting and anemia. A stenosis of the jejunum was documented by means of CT scan and video capsule enteroscopy. A laparoscopy was scheduled. A tumor, found in the first jejunal loop, was removed by laparoscopic surgery. Histopathology revealed a rare mucinous adenocarcinoma associated with epithelial changes secondary to celiac disease. Although small bowel tumors are rare entity, in patients with celiac disease complaining of symptoms related to altered intestinal transit or occult bleeding, an appropriate work-up should be planned for diagnosis. Mucinous type intestinal adenocarcinoma, even if never published before, could be observed. Laparoscopic surgery is often essential for the diagnosis and treatment.

摘要

小肠黏液腺癌非常罕见,文献中仅有少数病例报道。该肿瘤与乳糜泻的关联从未见诸报道。作者报告了一例独特的空肠黏液腺癌病例,其中组织学上确认伴有乳糜泻。讨论了诊断难点、腹腔镜手术的作用以及小肠肿瘤与乳糜泻之间的关系。一名49岁男性出现反复黑便、恶心、呕吐和贫血。通过CT扫描和视频胶囊内镜检查发现空肠狭窄。安排了腹腔镜检查。在空肠第一袢发现一个肿瘤,通过腹腔镜手术切除。组织病理学显示为罕见的黏液腺癌,伴有继发于乳糜泻的上皮改变。尽管小肠肿瘤是罕见疾病,但对于有乳糜泻且抱怨肠道转运改变或隐匿性出血相关症状的患者,应进行适当的检查以明确诊断。黏液型肠腺癌即便此前从未有过报道,也可能出现。腹腔镜手术对于诊断和治疗往往至关重要。

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