Alexander J R, Andrews J M, Buchi K N, Lee R G, Becker J M, Burt R W
Department of Medicine, University of Utah, Salt Lake City.
Dig Dis Sci. 1989 Feb;34(2):167-70. doi: 10.1007/BF01536046.
Eighteen consecutive asymptomatic patients with familial adenomatous polyposis (both familial polyposis coli and Gardener's syndrome) were studied over a 12-month period; side-viewing upper endoscopy and biopsy were used to assess the frequency of adenomatous polyps of the duodenal papilla. Nine of the 18 patients demonstrated adenomatous polyps of the papilla, varying in size and appearance from microadenomas in normal-appearing duodenal papillae (two) to a sessile polyp 3 cm in diameter. Two were tubulovillous adenomas (0.5 cm and 2 cm in diameter) and the remainder were tubular adenomas. Severe atypia and malignancy were not encountered. These findings reveal that adenomas of the duodenal papilla are common in individuals with familial adenomatous polyposis. Because of these findings and because of the known risk of periampullary adenocarcinomas and nonmalignant complications of polyps of the duodenal papilla in patients with familial adenomatous polyposis, upper gastrointestinal screening of such patients should include examination of the duodenal papilla with a side-viewing endoscope.
在12个月的时间里，对18例连续的无症状家族性腺瘤性息肉病患者（包括家族性结肠息肉病和加德纳综合征）进行了研究；采用侧视上消化道内镜检查和活检来评估十二指肠乳头腺瘤性息肉的发生率。18例患者中有9例表现出乳头腺瘤性息肉，其大小和外观各异，从外观正常的十二指肠乳头中的微腺瘤（2例）到直径3 cm的无蒂息肉不等。2例为管状绒毛状腺瘤（直径分别为0.5 cm和2 cm），其余为管状腺瘤。未发现严重异型增生和恶性病变。这些发现表明，十二指肠乳头腺瘤在家族性腺瘤性息肉病患者中很常见。鉴于这些发现以及已知家族性腺瘤性息肉病患者十二指肠乳头息肉有发生壶腹周围腺癌和非恶性并发症的风险，对此类患者进行上消化道筛查时应包括使用侧视内镜检查十二指肠乳头。
