Usui Y, Matsukawa M, Hamada T, Watanabe H, Kondo K, Kitamura S, Kuwabara N, Shirakabe H
Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
Gastroenterol Jpn. 1989 Aug;24(4):398-401. doi: 10.1007/BF02774346.
A 59-year-old female with depressive tendencies was admitted suffering from hematemesis and abdominal pain, two hours after ingestion of an unknown amount of toilet bowl cleaner (hydrochloric acid, pH 1.0). A barium study 24 days after ingestion revealed rigid narrowing and granulation of the entire stomach. The esophagus and duodenum were normal. The radiographic results were similar to those obtained for linitis plastica carcinoma of the stomach, but biopsy specimens of the stomach revealed no cancer cells. A total gastrectomy was performed about two months after ingestion to relieve the persistent feeling of nausea. Specimens revealed a rigid and thickening lining and a denuded mucosal surface of the stomach. The cut surface of the specimen showed a remarkable fibrous thickening of the submucosal layer. Microscopic examination failed to reveal a normal mucosal layer except in a narrow area of the fornix, and remarkable fibrosis of the submucosal lining was noted. No cancer cells were found. Corrosive gastritis has a linitis plastica appearance with a predilection for the antrum. Radiological examination revealed the very rare manifestation of a rigid narrowing of the whole stomach mimicking linitis plastica type cancer.
一名有抑郁倾向的59岁女性,在摄入未知量的马桶清洁剂(盐酸,pH值1.0)两小时后,因呕血和腹痛入院。摄入24天后的钡餐检查显示整个胃出现僵硬狭窄和颗粒状改变。食管和十二指肠正常。影像学结果与胃皮革胃样癌相似,但胃活检标本未发现癌细胞。摄入约两个月后进行了全胃切除术以缓解持续的恶心感。标本显示胃黏膜僵硬增厚,黏膜表面剥脱。标本切面显示黏膜下层明显纤维增厚。显微镜检查除穹窿部狭窄区域外未发现正常黏膜层,并注意到黏膜下衬里有明显纤维化。未发现癌细胞。腐蚀性胃炎呈皮革胃样外观,好发于胃窦部。放射学检查显示整个胃出现僵硬狭窄这一极为罕见的表现,类似皮革胃型癌。