You Kyoung Wan, Park Sang Wook, Lee Geum Soo, Kim Du Jin, Moon Hyeung Cheol, Hong Gun Young
Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea.
Clin Endosc. 2013 Mar;46(2):178-81. doi: 10.5946/ce.2013.46.2.178. Epub 2013 Mar 31.
Enteritis cystica profunda is a very rare disease in which a mucin-filled cystic space is surrounded partially with nonneoplastic columnar epithelium in the submucosa of the small intestine. Most of the cases are accompanied by intestinal diseases, and the disease usually occurs in the jejunum and the ileum and there has been no report of a case that occurred in the ampulla of Vater. A 58-year-old healthy female patient without any particular symptom visited the hospital to get additional examination for a mass found on the ampulla of Vater by accident. In esophagogastroduodenoscopy, a cystic mass showing a positive pillow sign was found on the ampulla of Vater. Endoscopic retrogradecholangiopancreatography was conducted as choledochocele was suspected, but no abnormality was found in the biliary system. In endoscopic ultrasonography, multiseptated cystic structures were detected in the submucosal layer of the duodenum. The lesion was resected completely through endoscopic snare polypectomy and the case was histologically diagnosed as enteritis cystica profunda.
深部囊性肠炎是一种非常罕见的疾病,其中充满黏液的囊性腔隙部分被小肠黏膜下层的非肿瘤性柱状上皮所包围。大多数病例伴有肠道疾病,该病通常发生在空肠和回肠,尚无发生在十二指肠乳头的病例报告。一名58岁无症状的健康女性患者因偶然发现十二指肠乳头有肿物而到医院进行进一步检查。在食管胃十二指肠镜检查中,在十二指肠乳头发现一个呈阳性枕征的囊性肿物。由于怀疑有胆总管囊肿,进行了内镜逆行胰胆管造影,但胆道系统未发现异常。在内镜超声检查中,在十二指肠黏膜下层检测到多房性囊性结构。通过内镜圈套息肉切除术将病变完全切除,组织学诊断为深部囊性肠炎。