Burud Ismail A S, Tata Mahadevan D, Tak Nor Akmar B
Department of Surgery, International Medical University Clinical Campus, Seremban, Malaysia.
Department of Surgery, Hospital Tuanku Ja'afar, Jalan Rasah, Seremban, Malaysia.
J Taibah Univ Med Sci. 2017 Nov 20;13(3):305-308. doi: 10.1016/j.jtumed.2017.10.004. eCollection 2018 Jun.
Hyperplastic polyps are the most common polypoidal lesions of the stomach showing a varied presentation. They may be asymptomatic; however, occasionally they can cause anaemia and gastric outlet obstruction. Malignant transformation is a serious complication associated with such polyps. We present the case of an elderly woman who complained of epigastric pain and intermittent vomiting. Oesophagogastroduodenoscopy (OGDS) showed a large pedunculated polyp along the lesser curvature of the stomach, 4 cm from the gastro-oesophageal junction, extending into the first part of the duodenum that caused gastric outlet obstruction. Computed tomography reported a soft-tissue mass arising from the incisura and extending through the pylorus into the duodenum (D1 and proximal D2). An endoscopic polypectomy was performed, and histopathological examination reported evidence of early gastric carcinoma. She underwent regular endoscopic follow-up with biopsies performed over 2 years, and the last follow-up showed mild-to-moderate dysplasia at the previous excision site. She underwent a planned laparoscopic wedge resection, and histopathological examination confirmed the presence of a hyperplastic polyp showing low-grade dysplasia.
增生性息肉是胃最常见的息肉样病变，表现多样。它们可能无症状；然而，偶尔可导致贫血和胃出口梗阻。恶变是与此类息肉相关的严重并发症。我们报告一例老年女性病例，她主诉上腹部疼痛和间歇性呕吐。食管胃十二指肠镜检查（OGDS）显示胃小弯处有一个带蒂大息肉，距胃食管交界处4厘米，延伸至十二指肠第一部，导致胃出口梗阻。计算机断层扫描报告显示有一个软组织肿块起自胃切迹，穿过幽门延伸至十二指肠（D1和近端D2）。进行了内镜下息肉切除术，组织病理学检查报告有早期胃癌的证据。她接受了为期2年的定期内镜随访并取活检，最后一次随访显示先前切除部位有轻度至中度发育异常。她接受了计划性腹腔镜楔形切除术，组织病理学检查证实存在一个显示低级别发育异常的增生性息肉。
