Ahn Ke Ryun, Koo Ja Seol, Kim Hwan Il, Kim Ji Hye, Lee Jee Hyun, Kim Seung Young, Jung Sung Woo, Lee Sang Woo
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
Clin Endosc. 2017 Nov;50(6):605-608. doi: 10.5946/ce.2017.026. Epub 2017 Oct 18.
Heterotopic gastric mucosa (HGM) is a rare anomaly in the small bowel and may be the cause of intussusception when it gets a lead point in the jejunum. All cases of intussusception due to intestinal HGM have been treated with surgical resection. A 5-year-old girl presented with chief complaints of vomiting and abdominal pain for 2 weeks. A computed tomography scan of the abdomen showed intussusception at the proximal jejunal loops. Three air reductions and one saline reduction were attempted without success. She continued to be symptomatic, and endoscopic evaluation was performed. Enteroscopy revealed some variable-sized polypoid mucosal lesions with erosions on the proximal jejunum. Endoscopic mucosal resection was performed using a snare. The resected tissues histologically showed a hyperplastic polyp arising from the HGM. Her symptoms did not recur within 1 year after the treatment. Our case showed that enteroscopy could be useful for the diagnosis and management of jejunal intussusception caused by HGM.
异位胃黏膜（HGM）是小肠中一种罕见的异常情况，当它在空肠形成一个引导点时，可能是肠套叠的原因。所有因肠道HGM导致的肠套叠病例均采用手术切除治疗。一名5岁女孩以呕吐和腹痛为主诉，持续2周。腹部计算机断层扫描显示近端空肠袢发生肠套叠。尝试了三次空气灌肠复位和一次盐水灌肠复位，但均未成功。她仍有症状，于是进行了内镜评估。小肠镜检查发现近端空肠有一些大小不一的息肉样黏膜病变，伴有糜烂。使用圈套器进行了内镜黏膜切除术。切除组织的组织学检查显示为起源于HGM的增生性息肉。治疗后1年内她的症状未复发。我们的病例表明，小肠镜检查对于诊断和处理由HGM引起的空肠肠套叠可能是有用的。
