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胶原性胃十二指肠炎症并存复发性迪厄拉富瓦溃疡:一例报告及无结肠受累的胶原性胃炎和胃十二指肠炎症综述

Collagenous gastroduodenitis coexisting repeated Dieulafoy ulcer: A case report and review of collagenous gastritis and gastroduodenitis without colonic involvement.

作者信息

Soeda Atsuko, Mamiya Takashi, Hiroshima Yoshinori, Sugiyama Hiroaki, Shidara Sayoko, Dai Yuichi, Nakahara Akira, Ikezawa Kazuto

机构信息

Department of Gastroenterology, Tsukuba Memorial Hospital, 1187-299 Kaname, Tsukuba, Ibaraki, Japan,

出版信息

Clin J Gastroenterol. 2014 Oct;7(5):402-9. doi: 10.1007/s12328-014-0526-y. Epub 2014 Aug 24.

Abstract

Collagenous gastritis (CG) is a rare disorder characterized by the thick collagenous subepithelial bands associated with mucosal inflammation. There have been approximately fifty reports in the literature since it was first described in 1989. According to previous reports, CG is heterogeneous and classified into two groups-(1) cases limited to the gastric mucosa in children or young adults, and (2) CG associated with collagenous colitis in elderly adults presenting with chronic watery diarrhea. In Japan, only nine previous cases were reported, and all of them were young adults. We report a case of CG with collagenous duodenitis in a 22-year-old female. She had repeated upper gastrointestinal bleeding from a Dieulafoy lesion of the fornix, but had no symptoms of malabsorption or diarrhea. Endoscopic findings revealed striking nodularity with a smooth islet-shaped normal area in the antrum and the body. The pathological findings of nodular mucosa showed the deposition of collagen bands just under the mucoepithelial lesion. In addition, she had collagenous duodenitis in part of the bulbs, and a colonoscopy showed no abnormalities. We provide a literature review of CG and collagenous gastroduodenitis without colonic involvement.

摘要

胶原性胃炎(CG)是一种罕见的疾病,其特征为与黏膜炎症相关的增厚的胶原性上皮下带。自1989年首次描述以来,文献中已有约50例报告。根据先前的报告,CG具有异质性,分为两组:(1)局限于儿童或年轻成人胃黏膜的病例;(2)与老年成人胶原性结肠炎相关的CG,伴有慢性水样腹泻。在日本,此前仅报告了9例病例,且均为年轻成人。我们报告一例22岁女性的伴有胶原性十二指肠炎的CG病例。她因穹窿部的Dieulafoy病变反复出现上消化道出血,但无吸收不良或腹泻症状。内镜检查发现胃窦和胃体有明显的结节状改变,中间有一个光滑的岛状正常区域。结节状黏膜的病理检查结果显示在黏液上皮病变下方有胶原带沉积。此外,她的十二指肠球部部分存在胶原性十二指肠炎,结肠镜检查未发现异常。我们对不伴有结肠受累的CG和胶原性胃十二指肠炎进行了文献综述。

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