Deng Shenghe, Cao Yinghao, Shen Liming, Wang Jiliang, Tao Kaixiong, Wang Guobin, Li Jiang, Cai Kailin
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2019 Apr;98(17):e15295. doi: 10.1097/MD.0000000000015295.
Gastritis cystica profunda (GCP) is a rare gastric lesion involving cystic dilation of the gastric glands extending into the submucosa. It is usually observed at anastomotic sites in the stomach of patients who have undergone gastric procedures. Bile reflux GCP is rare in patients who have not undergone gastric surgery. Here, we report a rare case of a patient with GCP associated with bile reflux, who had no history of gastric surgery.
A 50-year-old man presented with intermittent abdominal fullness for 2 years, along with nausea. He had never undergone gastric surgery. Endoscopic ultrasonography (EUS) showed a thickened gastric wall and an echo-poor submucosal layer of the gastric fundus. A 3 cm × 2 cm × 1.5 cm lesion was noted.
Bile reflux GCP INTERVENTIONS:: Endoscopic retrograde cholangiopancreatography and endoscopic submucosal dissection (ESD) were performed, and the lesion was removed. Conventional pathological examination revealed GCP with glands hyperplasia and a yellow-brown deposit, which was considered bile. The findings were consistent with a diagnosis of GCP without malignancy.
Upper gastrointestinal barium meal revealed postoperative changes at the gastric fundus. Gastroscopy performed at 6 months after surgical resection showed superficial gastritis with bile reflux.
The findings suggest that GCP etiology varies and that GCP can be caused by bile reflux but without malignancy. Additionally, GCP is not limited to patients who have previously undergone gastric surgery. Moreover, it is difficult to identify. EUS and ESD might be good approaches for the diagnosis and treatment of GCP.
深部囊性胃炎（GCP）是一种罕见的胃部病变，涉及胃腺向黏膜下层的囊性扩张。它通常在接受过胃部手术的患者胃的吻合部位观察到。胆汁反流性GCP在未接受过胃部手术的患者中很少见。在此，我们报告一例罕见的与胆汁反流相关的GCP患者，该患者无胃部手术史。
一名50岁男性，出现间歇性腹部饱胀2年，伴有恶心。他从未接受过胃部手术。内镜超声（EUS）显示胃壁增厚，胃底黏膜下层回声减低。发现一个3cm×2cm×1.5cm的病变。
胆汁反流性GCP
进行了内镜逆行胰胆管造影和内镜黏膜下剥离术（ESD），并切除了病变。常规病理检查显示GCP伴有腺体增生和黄褐色沉积物，考虑为胆汁。这些发现与无恶性肿瘤的GCP诊断一致。
上消化道钡餐显示胃底术后改变。手术切除6个月后进行的胃镜检查显示有胆汁反流的浅表性胃炎。
这些发现表明GCP的病因各不相同，胆汁反流可导致GCP，但无恶性肿瘤。此外，GCP并不局限于既往接受过胃部手术的患者。而且，它难以识别。EUS和ESD可能是诊断和治疗GCP的良好方法。
