质子泵抑制剂诱发的胃底腺息肉伴呕血

Proton-pump inhibitor-induced fundic gland polyps with hematemesis.

作者信息

Tanaka Mamoru, Kataoka Hiromi, Yagi Takashi

机构信息

Departments of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

出版信息

Clin J Gastroenterol. 2019 Apr;12(2):193-195. doi: 10.1007/s12328-018-0908-7. Epub 2018 Sep 24.

Abstract

Fundic gland polyps (FGPs) are generally considered benign. Proton-pump inhibitors (PPIs) are used worldwide as first-line therapy for gastroesophageal reflux disease and nonsteroidal anti-inflammatory drug-induced ulcer treatment. Long-term use of PPIs increases the risk of FGP development. We report an extremely rare case of PPI-induced FGPs with hematemesis. A 37-year-old woman taking daily rabeprazole presented to the hospital with a complaint of hematemesis and tarry stools. Esophagogastroduodenoscopy (EGD) revealed > 20 pedunculated polyps in the gastric body and fundus. Histological examination showed multiple fragments of fundic gland mucosa with dilated glands. Based on these findings and the clinical history, FGPs were diagnosed. Rabeprazole use was discontinued. Repeat EGD performed 9 months later showed a significant decrease in the number and size of the polyps. FGPs are small polyps typically located in the gastric corpus and fundus. They are commonly reported in patients in their 60s and predominantly in females. We conclude that PPI use is a risk factor for the development of FGPs and hematemesis.

摘要

胃底腺息肉(FGPs)通常被认为是良性的。质子泵抑制剂(PPIs)在全球范围内被用作胃食管反流病的一线治疗药物以及非甾体抗炎药所致溃疡的治疗药物。长期使用PPIs会增加FGP发生的风险。我们报告了一例极为罕见的因使用PPI导致FGPs并伴有呕血的病例。一名每天服用雷贝拉唑的37岁女性因呕血和黑便前来就诊。食管胃十二指肠镜检查(EGD)显示胃体和胃底有超过20个带蒂息肉。组织学检查显示胃底腺黏膜有多个片段,腺体扩张。基于这些发现和临床病史,诊断为FGPs。停用雷贝拉唑。9个月后复查EGD显示息肉的数量和大小显著减少。FGPs是通常位于胃体和胃底的小息肉。它们常见于60多岁的患者,且以女性为主。我们得出结论,使用PPI是FGPs发生和呕血的一个危险因素。

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