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经胶囊内镜和双气囊小肠镜诊断为导致隐匿性胃肠道出血的空肠炎性纤维瘤息肉的腹腔镜切除术:病例报告

Laparoscopic Resection of a Jejunal Inflammatory Fibroid Polyp that Caused Occult Gastrointestinal Bleeding, Diagnosed via Capsule Endoscopy and Double-Balloon Enteroscopy: A Case Report.

作者信息

Kameda Chizu, Miwa Hideaki, Kawabata Ryohei, Marukawa Daiki, Murakami Masahiro, Noura Shingo, Shimizu Junzo, Hasegawa Junichi

机构信息

Department of Surgery, Osaka Rosai Hospital, Osaka, Japan.

Department of Pathology, Osaka Rosai Hospital, Osaka, Japan.

出版信息

Clin Endosc. 2018 Jul;51(4):384-387. doi: 10.5946/ce.2017.162. Epub 2018 Mar 20.

Abstract

An inflammatory fibroid polyp (IFP) is a mesenchymal tumor of the gastrointestinal tract. IFPs in the small intestine are the most frequently detected with symptoms, such as abdominal pain and tarry stool due to intussusception. Accordingly, few studies have reported jejunal IFP as a cause of occult gastrointestinal bleeding (OGIB) diagnosed via both of capsule endoscopy (CE) and double-balloon enteroscopy (DBE). A 68-year-old woman presented with a progression of anemia and a positive fecal occult blood test result. Esophagogastroduodenoscopy and total colonoscopy findings were unremarkable. CE revealed a tumor with bleeding in the jejunum. DBE also revealed a jejunal polypoid tumor. Bleeding from the tumor seemed to have caused anemia. The patient underwent partial laparoscopic resection of the jejunum, including resection of the tumor. The tumor was histopathologically diagnosed as IFP. To our knowledge, this is the first reported case of laparoscopic resection of jejunal IFP with OGIB diagnosed via CE and DBE preoperatively.

摘要

炎性纤维瘤性息肉(IFP)是一种胃肠道间叶性肿瘤。小肠中的IFP最常出现症状,如因肠套叠导致的腹痛和柏油样便。因此,很少有研究报道空肠IFP是通过胶囊内镜(CE)和双气囊小肠镜(DBE)诊断出的隐匿性胃肠道出血(OGIB)的病因。一名68岁女性出现贫血加重且粪便潜血试验结果呈阳性。食管胃十二指肠镜检查和全结肠镜检查结果均无异常。CE显示空肠有一个伴出血的肿瘤。DBE也显示有空肠息肉样肿瘤。肿瘤出血似乎导致了贫血。患者接受了包括肿瘤切除在内的空肠部分腹腔镜切除术。该肿瘤经组织病理学诊断为IFP。据我们所知,这是首例术前通过CE和DBE诊断为OGIB的空肠IFP行腹腔镜切除术的报道病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ed/6078929/85fa091819c2/ce-2017-162f1.jpg

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