Bailey C E, Fritz M B, Webb L, Merchant N B, Parikh A A
Vanderbilt University Medical Center, Nashville, TN, US.
Ann R Coll Surg Engl. 2014 Jan;96(1):88E-90E. doi: 10.1308/003588414X13824511649977.
Gastric duplication cysts are rare cystic neoplasms that are often difficult to distinguish from other entities. We describe a healthy 44-year-old woman who presented with acute right lower quadrant abdominal and flank pain as well as chronic nausea and constipation. Her physical examination was unremarkable but contrasted computed tomography revealed a 6 cm cystic lesion between the stomach and body of the pancreas. Endoscopic ultrasonography and fluid analysis were consistent with a mucinous cyst with a markedly elevated fluid carcinoembryonic antigen level. The patient subsequently underwent a laparoscopic distal pancreatectomy, which was converted to an open procedure when the lesion was noted to be adherent to the coeliac axis. Intraoperative endoscopy revealed no abnormality. Final pathology revealed a gastric duplication cyst. The patient recovered well and was asymptomatic on follow-up. In this report, we discuss the incidence, natural history and management of this rare entity.
胃重复囊肿是罕见的囊性肿瘤,通常难以与其他病变相鉴别。我们描述了一名44岁健康女性,她出现急性右下腹和侧腹痛以及慢性恶心和便秘症状。她的体格检查无异常,但腹部增强CT显示胃和胰体之间有一个6厘米的囊性病变。内镜超声检查和液体分析结果与黏液性囊肿一致,液体癌胚抗原水平显著升高。该患者随后接受了腹腔镜远端胰腺切除术,术中发现病变与腹腔干粘连,遂转为开放手术。术中内镜检查未发现异常。最终病理检查显示为胃重复囊肿。患者恢复良好,随访时无症状。在本报告中,我们讨论了这种罕见病变的发病率、自然病程及治疗方法。