Teubner Daniel, Hoffman Arthur, Fisseler-Eckhoff Annette, Hüttenhain Thomas, Manner Hendrik, Kiesslich Ralf, Rey Johannes W
Klinik für Innere Medizin II, Helios Dr. Horst Schmidt Kliniken, Wiesbaden.
Institut für Pathologie, Helios Dr. Horst Schmidt Kliniken, Wiesbaden.
Dtsch Med Wochenschr. 2015 Oct;140(20):1539-42. doi: 10.1055/s-0041-106107. Epub 2015 Oct 7.
A 66-year-old woman suffering from skin paleness and weakness presented an increasing hypochromic, microcytic anemia. Diagnostic: In an ambulant setting a capsule endoscopy of the small intestine was carried out because of multiple polyps of the colon (colonoscopy) in addition to non-invasive (Hämoccult-Test) and invasive (gastroscopy) diagnostic. The patient was then admitted to hospital to clarify a suspicious ulcer of the small bowl. According to biopsies taken via balloon enteroscopy, an adenocarcinoma of the small intestine was diagnosed.
After staging and exploratory laparotomy, histology findings showed an advanced tumour stage. A palliative chemotherapy, analogue to colon cancer treatment, was conducted.
Small bowel diagnostics should be carried out if the aetiology of an anemia is not certain with an existing polyposis of the colon. Individuals with personal or family history of cumulative colorectal adenomas should undergo assessment for an adenomatous polyposis syndrom.
一名66岁女性,有皮肤苍白和虚弱症状,出现了日益加重的低色素性小细胞贫血。诊断:在门诊环境中,由于结肠多发息肉(结肠镜检查),除了进行非侵入性(隐血试验)和侵入性(胃镜检查)诊断外,还对小肠进行了胶囊内镜检查。患者随后入院以明确小肠一处可疑溃疡的情况。根据经气囊小肠镜检查获取的活检结果,诊断为小肠腺癌。
在进行分期和探查性剖腹手术后,组织学检查结果显示为晚期肿瘤阶段。进行了类似于结肠癌治疗的姑息化疗。
如果贫血病因不明且存在结肠息肉病,应进行小肠诊断。有个人或家族性累积性结直肠腺瘤病史的个体应接受腺瘤性息肉病综合征的评估。